Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island.
Medical Professional Liability Association, Department of Research and Education, Rockville, Maryland.
West J Emerg Med. 2021 Feb 15;22(2):333-338. doi: 10.5811/westjem.2020.9.48845.
This study reviews malpractice, also called medical professional liability (MPL), claims involving adult patients cared for in emergency departments (ED) and urgent care settings.
We conducted a retrospective review of closed MPL claims of adults over 18 years, from the Medical Professional Liability Association's Data Sharing Project database from 2001-2015, identifying 6,779 closed claims. Data included the total amount, origin, top medical specialties named, chief medical factors, top medical conditions, severity of injury, resolution, average indemnity, and defense costs of closed claims.
Of 6,779 closed claims, 65.9% were dropped, withdrawn, or dismissed. Another 22.8% of claims settled for an average indemnity of $297,709. Of the 515 (7.6%) cases that went to trial, juries returned verdicts for the defendant in 92.6% of cases (477/515). The remaining 7.4% of cases (38/515) were jury verdicts for the plaintiff, with an average indemnity of $816,909. The most common resulting medical condition cited in paid claims was cardiac or cardiorespiratory arrest (10.4%). Error in diagnosis was the most common chief medical error cited in closed claims. Death was the most common level of severity listed in closed (38.5%) and paid (42.8%) claims. Claims reporting major permanent injury had the highest paid-to-closed ratio, and those reporting grave injury had the highest average indemnity of $686,239.
This retrospective review updates the body of knowledge surrounding medical professional liability and represents the most recent analysis of claims in emergency medicine. As the majority of emergency providers will be named in a MPL claim during their career, it is essential to have a better understanding of the most common factors resulting in MPL claims.
本研究回顾了医疗事故责任（MPL）索赔，这些索赔涉及在急诊部门（ED）和紧急护理环境中接受治疗的成年患者。
我们对 2001 年至 2015 年期间，来自医疗专业责任协会数据共享项目数据库中的 18 岁以上成年人的已结案 MPL 索赔进行了回顾性审查，共确定了 6779 份已结案索赔。数据包括总金额、来源、排名最高的医学专业、主要医疗因素、排名最高的医疗状况、伤害严重程度、解决结果、平均赔偿额和已结案索赔的辩护费用。
在 6779 份已结案索赔中，65.9%被撤销、撤回或驳回。另有 22.8%的索赔以 297709 美元的平均赔偿金解决。在 515 件（7.6%）进入审判的案件中，陪审团在 92.6%的案件中（477/515）做出了有利于被告的裁决。其余 7.4%（38/515）的案件为陪审团对原告的裁决，平均赔偿金为 816909 美元。在已支付的索赔中，最常见的索赔医疗状况是心脏或心肺骤停（10.4%）。在已结案的索赔中，错误诊断是最常见的主要医疗错误。在已结案（38.5%）和已支付（42.8%）索赔中，死亡是最常见的严重程度级别。报告重大永久性损伤的索赔获得的赔偿与结案比最高，报告严重损伤的索赔平均赔偿额最高，为 686239 美元。
本回顾性研究更新了围绕医疗事故责任的知识体系，代表了对急诊医学索赔的最新分析。由于大多数急诊医生在职业生涯中都会被提起医疗事故责任诉讼，因此更好地了解导致医疗事故责任诉讼的最常见因素至关重要。
