Marshall Deborah, Tringale Kathryn, Connor Michael, Punglia Rinaa, Recht Abram, Hattangadi-Gluth Jona
Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California.
Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; University of California Irvine School of Medicine, Irvine, California.
Int J Radiat Oncol Biol Phys. 2017 May 1;98(1):21-30. doi: 10.1016/j.ijrobp.2017.01.022. Epub 2017 Jan 16.
To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period.
Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression.
There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included "improper performance" (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), "errors in diagnosis" (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and "no medical misadventure" (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. "Improper performance" was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment.
Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care and minimize the risk of being sued.
研究在10年期间结案的涉及放射肿瘤学家的医疗事故索赔的特征。
对一家全国性责任保险行业协会收集的2003年至2012年针对放射肿瘤学家提出的医疗事故索赔进行分析。结果包括索赔的性质和赔偿支付情况,包括相关的初始诊断、治疗程序、所称医疗差错以及伤害严重程度。我们使用二项逻辑回归比较了与伤害严重程度类别(以死亡为参照)相关的索赔获得赔偿的可能性。
共有362起涉及放射肿瘤学的结案索赔,其中102起(28%)获得赔偿,赔偿总额达3800万美元。最常见的所称差错包括“操作不当”(占结案索赔的38%,其中18%获得赔偿;占总赔偿额的29%[1100万美元])、“诊断错误”(占结案索赔的25%,其中46%获得赔偿;占总赔偿额的44%[1700万美元])以及“无医疗意外”(占结案索赔的14%,其中8%获得赔偿;占总赔偿额不到1%[14.8万美元])。32%的索赔中提到了另一名医生,18%的索赔中提到了同意问题/违反合同。导致死亡的伤害索赔占结案索赔的39%,占总赔偿额的25%。“操作不当”是与导致死亡的伤害相关的主要所称差错。与涉及死亡的索赔相比,重大暂时性伤害(优势比[OR]2.8,95%置信区间[CI]1.29 - 5.85,P = 0.009)、重大永久性伤害(OR 3.1,95%CI 1.48 - 6.46,P = 0.003)和严重永久性伤害(OR 5.5,95%CI 1.89 - 16.15,P = 0.002)导致索赔获得赔偿的可能性更高。
操作不当是最常见的所称医疗事故差错。涉及重大或严重伤害的索赔比涉及死亡的索赔更有可能获得赔偿。对针对放射肿瘤学家的责任索赔性质的深入了解可能有助于指导提高医疗质量的努力,并将被起诉的风险降至最低。