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来自单一机构的10年辅助生殖技术医疗事故索赔结果。

Outcomes of medical malpractice claims in assisted reproductive technology over a 10-year period from a single carrier.

作者信息

Letterie Gerard

机构信息

Seattle Reproductive Medicine, 1505 Westlake Suite 400, Seattle, WA, 981105, USA.

出版信息

J Assist Reprod Genet. 2017 Apr;34(4):459-463. doi: 10.1007/s10815-017-0889-3. Epub 2017 Feb 11.

Abstract

OBJECTIVE

Medical malpractice claims vary by specialty. Contributory factors to malpractice in reproductive endocrinology and infertility (REI) are not well defined. We sought to determine claims' frequency, basis of claims, and outcomes of settled claims in REI.

DESIGN

This is a retrospective, descriptive review of 10 years of claims.

SETTING

The setting is private practices.

MATERIALS AND METHODS

Claims were monitored within one malpractice carrier between 2006 and 2015 covering 10 practices and 184,015 IVF cycles. Total claims, basis of claims, and indemnity paid were evaluated.

RESULTS

There were 176 incidents resulting in 30 settled claims with indemnity payments in 21. Categories of claims settled included misdiagnosis (N = 4), lack of informed consent (N = 5), embryology errors (N = 8), and surgical complications (N = 4). Total and average awards were $15,062,000 and $717,238, respectively. Misdiagnosis and lack of informed consent had highest total award amount at $11,583,000 accounting for 76% of award dollars. The two highest awards were $4.5 million and $3.0 million for cancer and genetic misdiagnosis, respectively. Excluding these two awards, payments totaled $7,562,000, ranged from $6000 to $900,000 and averaged $170,363. Errors in handling of embryos were highest in frequency accounting for 38% of claims paid for a total of $1,593,000 with average payment of $199,188. Settlements for surgical complications totaled $1,855,000 and averaged $463,750 per claim.

CONCLUSIONS

Misdiagnosis and lack of informed consent are the highest award categories. Embryology lab errors are the most frequent causes of claims with the lowest award per settlement. The average cost for claims settled is relatively high compared to settlements in other specialties.

摘要

目的

医疗事故索赔因专业不同而有所差异。生殖内分泌与不孕症(REI)领域医疗事故的促成因素尚未明确界定。我们试图确定REI领域索赔的频率、索赔依据以及已结案索赔的结果。

设计

这是一项对10年索赔案例的回顾性描述性研究。

背景

研究背景为私人诊所。

材料与方法

对2006年至2015年期间一家医疗事故保险公司承保的10家诊所的184,015个体外受精周期内的索赔情况进行监测。评估了总索赔数、索赔依据以及已支付的赔偿金。

结果

共发生176起事件,导致30起索赔结案并支付了赔偿金,涉及21个类别。已结案的索赔类别包括误诊(N = 4)、缺乏知情同意(N = 5)、胚胎学错误(N = 8)和手术并发症(N = 4)。总赔偿金额和平均赔偿金额分别为15,062,000美元和717,238美元。误诊和缺乏知情同意的总赔偿金额最高,为11,583,000美元,占赔偿金额的76%。两项最高赔偿分别为癌症和基因误诊的450万美元和300万美元。排除这两项赔偿后,支付总额为7,562,000美元,范围从6000美元到900,000美元,平均为170,363美元。胚胎处理错误的频率最高,占已支付索赔的38%,总计1,593,000美元,平均每次支付199,188美元。手术并发症的赔偿金总计1,855,000美元,平均每项索赔463,750美元。

结论

误诊和缺乏知情同意是赔偿金额最高的类别。胚胎学实验室错误是索赔最常见的原因,但每次结案的赔偿金额最低。与其他专业领域的索赔结案相比,已结案索赔的平均成本相对较高。

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