Article Figures & Data
Figures
- Figure 1.
Percent of paid family medicine claims and degree of injury histogram of degree of injury, measured by the severity index of the National Association of Insurance Commissioners, and the percentage of closed family medicine claims that resulted in payment to the plaintiff in the Physician Insurers Association of America Data Sharing Project registry for the period 1985 to 2008.
Tables
Specialty Closed Claims (n) Paid Claims (n) Paid to Closed (%) Total Indemnity ($) Average Indemnity ($) Median Indemnity ($) Largest Payment ($) Anesthesiology 9,231 2,970 32.2 671,350,918 226,044 75,000 5,048,678 Cardiovascular and thoracic surgery 7,283 1,712 23.5 378,126,443 220,868 100,000 5,005,000 Cardiology 4,527 836 18.5 209,856,413 251,024 150,000 1,950,000 Dentistry 867 378 43.6 15,572,767 41,198 15,000 1,000,000 Dermatology 2,704 775 28.7 106,592,226 137,538 35,000 3,000,000 Emergency medicine 4,341 1,131 26.1 225,069,207 199,000 85,000 2,000,000 Gastroenterology 2,506 453 18.1 98,509,776 217,461 100,000 2,900,000 Family medicine 27,556 8,797 31.9 1,443,653,088 164,107 75,000 4,089,414 General surgery 24,998 8,551 34.2 1,577,752,573 184,511 87,500 3,116,180 Gynecology 2,840 863 30.4 135,783,680 157,339 60,000 2,000,000 Internal medicine 32,651 8,216 25.2 1,749,471,776 212,935 100,000 12,000,000 Neurology 3,826 825 21.6 263,991,984 319,990 150,000 5,000,000 Neurosurgery 5,620 1,585 28.2 499,918,893 315,406 170,000 5,600,000 Obstetrics and gynecology 32,662 11,488 35.2 3,257,179,047 283,529 125,000 13,000,000 Ophthalmology 6,947 1,995 28.7 367,850,385 184,386 100,000 3,550,000 Oral surgery 65 21 32.3 548,583 26,123 12,500 133,500 Orthopedics 22,538 6,599 29.3 1,099,243,175 166,577 80,000 3,000,000 Nonsurgical specialties 2,396 558 23.3 112,652,994 201,887 55,625 8,749,980 Otorhinolaryngology 3,990 1,262 31.6 257,848,881 204,318 100,000 4,000,000 Paraprofessional 417 98 23.5 19,637,949 200,387 92,000 1,322,290 Pathology 1,685 477 28.3 117,418,795 246,161 119,999 2,700,000 Pediatrics 7,001 1,951 27.9 526,796,951 270,014 125,000 5,250,000 Plastic surgery 8,910 2,346 26.3 276,760,588 117,971 46,260 1,650,000 Psychiatry 2,348 474 20.2 77,760,608 164,052 55,000 2,375,000 Radiation therapy 2,328 662 28.4 193,576,117 292,411 140,000 2,700,000 Radiology 13,592 3,977 29.3 803,819,037 202,117 90,000 3,125,000 Resident 133 44 33.1 2,689,932 61,135 74,500 200,000 Urology 5,794 1,695 29.3 306,063,041 180,568 90,000 3,200,000 Totals 239,756 70,739 29.5 14,795,495,827 209,156 90,000 13,000,000 Medical Misadventure Closed Claims (n) Paid Claims (n) Paid to Closed (%) Average Indemnity ($) Errors in diagnosis 8,726 3,235 37.1 185,615 None noted 4,587 371 8.1 168,727 Improper performance 3,886 1,454 37.4 128,618 Failure to supervise or monitor case 2,570 838 32.6 163,598 Medication errors 2,500 811 32.4 109,758 Failure or delay in referral or consultation 905 421 46.5 192,261 Failure to perform 794 355 44.7 199,708 Failure to recognize a complication of treatment 759 269 35.4 160,775 Failure to instruct or communicate with patient 576 157 27.3 179,535 Delay in performance 573 274 47.8 211,826 Total 25,876 8,185 31.6 165,852 Condition Closed Claims (n) Paid Claims (n) Paid to Closed (%) Average Indemnity ($) Myocardial infarction, acute 351 178 50.7 206,156 Malignant neoplasms of the female breast 311 136 43.7 195,857 Appendicitis 286 123 43.0 76,743 Malignant neoplasms of the bronchus and lung 257 94 36.6 127,260 Malignant neoplasms of the colon and rectal region 248 112 45.2 188,197 Symptoms involving abdomen and pelvis 197 54 27.4 285,306 Chest pain, not further defined 138 61 44.2 342,335 Pneumonia 133 46 34.6 183,119 Meningitis 114 59 51.8 221,914 Coronary atherosclerosis 99 51 51.5 165,758 Pulmonary embolism 94 49 52.1 284,176 Diabetes 93 36 38.7 179,161 Aortic aneurysm 92 42 45.7 171,071 Wrist bones, fracture of 83 36 43.4 52,808 Disorders of soft tissue 79 28 35.4 193,952 Disorder of joint, not including arthritis 76 21 27.6 173,202 Fracture of vertebral column 76 30 39.5 177,401 Back disorders, including lumbago and sciatica 74 22 29.7 389,545 Malignant neoplasms of the prostate 72 28 38.9 209,030 Endocarditis, acute 69 36 52.2 286,871 - Table 4.
Ten Most Prevalent Associated Medical Issues in Family Medicine Closed Claims 1985–20086 (n = 18,031)
Associated Medical Issue Closed Claims (n) Paid Claims (n) Paid to Closed (%) Average Indemnity ($) Equipment malfunction 1,189 82 6.9 162,685 Problem with records 846 566 66.9 184,511 Problem with history or examination 716 311 43.4 339,189 Communications between providers 507 223 44.0 253,078 X-ray error 390 153 39.2 159,938 Improper conduct by physician 330 107 32.4 79,372 Premature discharge 298 153 51.3 208,556 Lack of adequate facilities 248 106 42.7 237,646 Comorbid conditions 202 39 19.3 315,317 Unnecessary treatment 132 40 30.3 167,810 - Table 5.
Ten Most Prevalent Associated Legal Issues in Family Medicine Closed Claims 1985–20086 (n = 18,031)
Associated Legal Issue Closed Claims (n) Paid Claims (n) Paid to Closed (%) Average Indemnity ($) Informed consent 1,728 354 20.5 106,326 Vicarious liability 877 252 28.7 136,611 Punitive damages 492 118 24.0 174,606 Abandonment 213 70 32.9 144,571 Failure to conform with rules, regulations 152 76 50.0 206,719 Third party claimant 87 14 16.1 194,116 Breach of Confidentiality 134 16 11.9 42,378 Assault and battery 112 42 37.5 92,197 Res ipsa loquitur 65 26 40.0 211,510 False imprisonment 21 7 33.3 22,357 Associated Professional Personnel Closed Claims (n) Paid Claims (n) Paid to Closed (%) Average Indemnity ($) Other physician 7,812 2,327 29.8 178,262 Consultant 1,654 590 35.7 198,607 Nurse 1,300 535 41.2 155,228 Emergency room physician 1,061 434 40.9 167,115 Radiologist 1,056 408 38.6 171,686 Manufacturer of drug or equipment 649 1 0.2 1,000,000 Physician assistant 464 165 35.6 165,569 Other hospital personnel 459 189 41.2 114,968 Resident or intern 440 207 47.0 205,967 Technician 279 108 38.7 119,747 Procedure Performed Closed Claims (n) Paid Claims (n) Paid to Closed (%) Total Indemnity ($) Average Indemnity ($) Diagnostic interview, evaluation, or consultation 8,307 2,480 29.9 438,144,458 176,671 Prescription of medication 5,159 1,605 31.1 214,309,905 133,526 General physical examination 2,367 720 30.4 156,808,468 217,790 No care rendered 1,153 133 11.5 14,273,164 107,317 Miscellaneous manual examinations and nonoperative procedures 859 332 38.7 67,232,400 202,507 Injections and vaccinations 731 329 45.0 35,274,714 107,218 Operative procedures on the skin, excluding skin grafts 572 236 41.3 16,197,136 68,632 Diagnostic radiologic procedures, excluding CAT scan and contrast material 413 143 34.6 16,320,721 114,131 Diagnostic procedures involving cardiac and circulatory functions 365 174 47.7 49,747,032 285,902 Manually assisted deliveries 342 153 44.7 47,601,072 311,118 Totals 20,268 6,305 31.1 1,055,909,070 167,472 CAT, computed axial tomography.
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