Judgment errors rank among top reasons for lawsuits against obstetricians

The average payout is $947,000, more than twice that of other specialties.

By — Posted June 28, 2011

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Errors in clinical judgment, miscommunication and technical mistakes are the three top reasons cited for medical liability cases against obstetricians, according to a report.

The study, released in June by CRICO Strategies, analyzed the causes behind more than 800 obstetrician-related medical liability cases filed between 2005 and 2009. CRICO Strategies is an international company that provides risk management software and other services to hospitals and medical liability insurers.

The cases studied were taken from CRICO's data collection of 120,000 medical liability claims.

Clinical judgment error was cited in 77% of the cases. Miscommunication was mentioned in 36% of the cases, and technical error was noted 26% of the time. Other reasons listed were inadequate documentation, administrative failures and ineffective supervision (link).

The three most common allegations within claims were:

  • Delayed treatment of fetal distress.
  • Improper execution of vaginal delivery.
  • Improper management of pregnancy.

The report illustrates how liability in these cases rarely stems from a single act by one health professional but usually is the result of a series of missteps by a medical team, said Robert Hanscom, senior vice president of CRICO Strategies.

"Obstetrics has some unique vulnerabilities, most often involving situations in which a sequence of errors or oversights cascade into a crisis that can put mother and baby in jeopardy," he said in a statement. "It is absolutely paramount that [obstetric] practices understand how these missteps unfold, and then focus on education and training initiatives designed specifically to help clinicians avert those mistakes."

The report's findings were not surprising, said Albert L. Strunk, MD, deputy executive vice president of the American Congress of Obstetricians and Gynecologists. "There is a substantial body of data that confirms the [results] of this report. The big factors in success are team training and improved communication," he said.

Dr. Strunk said maternity is significantly safer than it was 50 years ago. Still, claims that go forward result in higher than average legal costs for the profession, he said.

The rate of obstetric lawsuits is less than one case per 1,000 births. But the average payment for a medical liability case is about $947,000, more than twice that of other specialties.

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