Presenting Author:

Laura Matthews, M.D.

Principal Investigator:

Magdy Milad, M.D.

Department:

Obstetrics and Gynecology

Keywords:

Medico-legal, litigation; gynecologic surgery; intra-operative complications

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C65 - Clinical Women's Health Research

Trends in Obstetric and Gynecologic Surgical Malpractice Claims

Objective To evaluate recent trends in surgical obstetrics and gynecology malpractice claims and compare these to other medical specialties. Methods A search was performed on all medicolegal claims data in obstetrics and gynecologic surgery using the PIAA (Physician Insurers Association of America) data sharing project, created to identify medical professional liability trends in obstetric and gynecologic surgery between January 1, 2005 and December 31, 2014. Data from 20 insurance carriers were reviewed based on a search using ICD-9 codes and unique database-specific codes. Results A total of 10,915 OB/GYN surgical claims were closed between 2005 and 2014. Of these, 31.1% were paid with an average indemnity of $423,250. The most frequently litigated procedures were “operative procedures on the uterus”; 27.8% of cases were paid with an average indemnity of $279,384. The most prevalent medical factor associated with closed surgical claims was "improper performance of a procedure", which was associated with 40% of claims. The average indemnity for paid obstetrics and gynecology surgical claims was 27% higher than that for all medical specialties combined. Obstetrics and gynecology surgical claims had the second highest average indemnity payment and the fifth highest paid-to-closed ratio of all medical specialties. Conclusion Litigation claims in obstetric and gynecologic surgery have higher average indemnity payments and higher paid-to-closed ratios than most other medical specialties. Claims most frequently relate to gynecologic procedures, but obstetric procedures are more expensive. Related factors may include surgical volume and unique peri-operative complications. It is crucial that we address this through litigation education and quality interventions such as shared patient decision making.