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More than three-quarters of medical malpractice allegations related to surgery are performance-related, says a report issued by medical liability insurer Coverys on Tuesday.
Coverys’ report, Surgery Risks: Through the Lens of Malpractice Claims, is based on 2,579 surgery or related closed malpractice claims during the 2014-2018 period. Surgery was the second most common cause for claims overall, accounting for 25% of all claims, with diagnosis-related claims the most common cause, accounting for 32% of the total.
“In an era of productivity and profitability, surgeons and their supporters are challenged to do more with less time,” says the report. “More procedures, more patients, more billing codes. And those pressures can have patient safety consequences,” said the report.
In examining the reasons behind surgical-related claims, 78% were related to performance, with the second most common allegation “retained foreign body,” accounting for just 7% of the cases, according to the report.
A total of 29% of surgery injuries were considered “permanent significant, or worse,” with 9% resulting in death, according to the report.
A total of 27% of surgical claims allege a failure in clinical judgment and or/communication, according to the report. Just three surgical categories out of a total of more than 50 account for 47% of claims: general surgery, 22%; orthopedic surgery, 17%; and neurosurgery, 8%.
“Coverys data shows that patients continue to undergo surgeries that are arguably unnecessary (triggering 4% of surgical claims) or contraindicated (1% of claims),” said the report.
“While these percentages are low, they can be reduced through practices related to taking a thorough history and physical…as well as improved communication and documentation to ensure that the only patients having surgery are the ones who need and/or want it,” said the report.
Another issue is patient consent, said the report. “We continue to see cases in which detailed patient consent forms are not provided in the patient’s preferred language and those in which procedures (and their risks) are not fully explained to patients and their families,” said the report.
“Great strides can still be made to develop and execute processes and scripts for explaining the nature of a surgery – and the risks benefits, or alternative(s) to it – and subsequently ensuring patient understanding,” it said.
A report issued by Coverys last year said the top allegation for primary care providers involves inadequate patient assessment, which includes the capture of a complete family history, followed by the ordering of lab and diagnostic tests.
Self-insured hospital professional liability claims remain stable overall, but the frequency and severity of large excess claims continues to increase amid a rising number of large medical malpractice verdicts, according to a new report.