Cataract, corneal surgeries most likely to result in ophthalmology malpractice claims

This review of data from the Physician Insurers Association of America professional liability registry examined claims against ophthalmologists over a 10-year period.

Study design

The authors retrospectively analyzed medical professional liability claims between 2006 and 2015 using records from the Physician Insurers Association of America Data Sharing Project. They compared ophthalmology and all other healthcare specialties with regards to physician demographics, frequency of claims and costs associated with closed claims and claim resolution.

Outcomes

Overall, 2.2% of all paid medical claims were against ophthalmologists. Of 30 medical specialties, ophthalmology ranked 17^th for total indemnity payments and 20^th for average indemnity payment. 

A total of 2,325 ophthalmology claims were closed, with a 24% rate of payment. The 564 paid ophthalmology claims encompassed more than $158 million. Cataract and myopia were the presenting conditions most likely to result in a claim. Cataract surgery and corneal surgery were the procedures most associated with a closed claim. Although corneal conditions ranked 10^th in prevalence for presenting conditions, they were associated with the highest average indemnity payment.

Limitations

The number of claims is known, but denominator data are missing. The study explores presenting diagnoses and surgical procedures but does not delineate risk factors that cataract and refractive surgeons should watch for.

Clinical significance

Cataract and refractive surgeons may pay more per professional liability claim than other ophthalmology subspecialists. Careful informed consent and attentive follow up are critical given the high volume of cataract and refractive surgeries, the possibility of out-of-pocket payments and high patient expectations.