Knowledge holds power to increase patient safety and reduce clinical risk.

Patient Safety Claims Analysis: Delivering targeted malpractice prevention education

In an effort to understand risk trends in lawsuits and deliver a targeted education program to our insureds, The Mutual’s patient safety team embarked on a claims analysis project in early 2022. Reviewing all lawsuits with a date of incident between 2016 and 2021, we coded each case by medical condition, contributing factors, associated specialty, type of involved care providers, comorbid conditions, and more. This project identified the six most frequently occurring medical conditions and associated risk factors in lawsuits across the medical specialties we insure.

Our data is consistent with other professional liability data industry wide. Infection, which includes sepsis, necrotizing fasciitis, and meningitis cases, is our most frequently litigated medical condition. This is followed by fractures, stroke, cardiac, spinal emergencies and altered level of consciousness (ALOC). ALOC is the least frequently litigated category on our list. Though rare, these cases can arise on any given day for practicing providers. Factors contributing to litigation of these cases include discharges of intoxicated patients and administration of medications to manage rarely encountered conditions. Within each of the six categories are stories of patient care with clinical learning points even the most seasoned physician or advanced provider will appreciate.

Patient harm and litigation outcomes vary in severity in this data set, but each case is emotionally and financially costly. Two associated factors driving risk exposure stand out clearly in this analysis. Anchoring bias leads to inadequate work-up and consideration of a broader differential. The best way to mitigate this risk is using the cognitive pause at critical decision points in care, especially discharge. Additionally, inadequate documentation of either the exam or medical decision-making thought process create hurdles in defense strategy we want to help you avoid.

Leveraging this data, industry research and our close relationship with Vituity Risk, we target identified risk trends in the education we provide through site seminars, presentations, and newsletters.