What are the most common issues that lead to malpractice cases in healthcare?

Most Common Issues in Medical Malpractice Cases

Failure to diagnose and failure to treat are the most common allegations leading to medical malpractice cases, particularly in acute conditions such as stroke. 1

Key Factors in Malpractice Claims

Diagnostic Failures

• Diagnostic errors account for the majority of malpractice claims
  • 72.1% of primary care malpractice claims are related to diagnosis 2
  • Failure to timely diagnose is particularly common in emergency settings 1
  • Premature closure (ending diagnostic process too early) is a significant factor 1

Communication Failures

• Communication failures are identified in 49% of malpractice claims 3
  • 53% involve provider-patient miscommunication
  • 47% involve provider-provider miscommunication
• Most commonly miscommunicated information includes:
  • Contingency plans
  • Diagnosis details
  • Illness severity
• Failed handoffs account for 40% of communication failures 3
• Claims with communication failures have significantly higher costs ($237,600 vs $154,100) 3

Treatment Errors

• Medication errors are particularly common:
  • In pediatric settings, 5.7% of medication orders contain errors 1
  • In outpatient settings, medication errors account for 85% of medical treatment errors 1
  • Dosing calculations are especially problematic in pediatrics 1

Financial Impact

• Average settlement payout: $1,802,693 (median $1,000)
• Average plaintiff verdict payout: $9,705,099 1
• More severe injuries lead to higher payouts, with severe injury resulting in higher payouts than death 1

Case Outcomes

• Overall outcomes of malpractice cases:
  • 56% result in no payout
  • 27% are settled out of court
  • 17% go to trial with plaintiff verdict 1
• Primary care cases are more likely to be settled (35.2% vs 20.5%) or result in a verdict for the plaintiff (1.6% vs 0.9%) compared to other medical malpractice claims 2

High-Risk Specialties and Settings

• Emergency departments are high-risk settings due to:
  • Time pressure
  • Patient handoffs
  • Communication challenges between providers 1
• Primary care faces significant risk:
  • Cancer is the leading diagnosis in primary care malpractice claims 2
  • Heart disease, vascular disease, infections, and stroke are other common diagnoses in claims 2
• Surgical specialties have some of the highest litigation rates 4

Prevention Strategies

Improve Communication

• Implement standardized handoff processes 1
• Enhance communication between providers and patients 1
• Ensure timely follow-up with patients and families 5
• Respond promptly to phone calls or pages 5

Develop a Culture of Safety

• Focus on systems improvement rather than blaming individuals 1, 5
• Implement peer review mechanisms 5
• Encourage reporting of errors and near-misses 5
• Use adverse events as opportunities for improvement 5

Documentation Best Practices

• Maintain complete and accurate medical records 5
• Document informed consent discussions thoroughly
• Ensure proper documentation when dispensing medication samples 1

Common Pitfalls to Avoid

1. Telephone-only consultations: Cases where physicians were named as defendants based solely on telephone advice have resulted in significant liability 1

2. Failure to transfer or refer: Allegations of failure to timely transfer to another hospital commonly result in payouts (>60% of cases) 1

3. Discharge without adequate follow-up: 36% of claims involved patients discharged from hospitals who were subsequently found to have suffered a stroke 1

4. Post-procedural monitoring failures: 14.7% of malpractice cases involved strokes occurring after surgical procedures 1

5. Overreliance on initial diagnosis: Premature closure in diagnostic reasoning is a significant factor in errors 1

By understanding these common issues in malpractice cases, healthcare providers can implement targeted strategies to improve patient safety and reduce liability risk.