Surgeon Wins Again in Lawsuit Appeal; More

Wayne J. Guglielmo, MA


April 16, 2019

In This Article

Misdiagnosis Leads to Most Med-Mal Claims

The most common reason for medical malpractice claims is misdiagnosis, according to two recently released studies that were reported in the Claims Journal, among other news outlets.[2]

The first study was conducted by Coverys, a Boston-based liability insurance provider. Examining 1800 primary care–related closed claims from 2013 to 2017, analysts found that 46% involved diagnostic errors, accounting for 68% of total indemnity payouts. In 45% of these cases, the patient died.[3]

The most frequent diagnostic-related allegation against primary care providers (PCPs) was inadequate patient assessment, including the failure to establish a complete family history or conduct a thorough physical examination. The second leading category of claims filed against PCPs (20%) involved medical treatment, and specifically the use of "nonprocedural therapies" in cases involving cardiac care, pain management, wound care, and administration of blood products.

"Primary care physicians play a critical role in the delivery of a timely and accurate diagnosis, selection of treatment therapies, and monitoring of high-risk medications," said Robin Webster, senior risk consultant at Coverys and coauthor of the study. "Failure to correctly assess patient conditions during these complex phases of care can result in significant patient harm."

The second study, which focused on pediatric claims, was conducted by The Doctors Company of Napa, California, the nation's largest physician-owned medical malpractice insurer. After reviewing 1215 child-related claims and lawsuits that closed between 2008 and 2017, analysts found that diagnosis-related allegations accounted for[4]:

  • 44% of claims for patients aged 1-11 months

  • 38% of claims for patients aged 1-9 years

  • 34% of claims for patients aged 10-17 years

According to the study, when treating children in these age ranges, physicians who conducted inadequate patient assessments or communicated poorly with either the patient or family members were more likely to make an incorrect diagnosis, thereby posing a greater risk to their patients.

Tips offered by The Doctors Company for mitigating risk when treating children include ensuring quality documentation and an adequate exchange of information, conducting thorough reevaluations when patients return with the same or worsening symptoms, and providing parents and guardians with information to help them recognize when a sick child requires emergency care.


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