Ophthalmology, May 2018
Thompson et al. assessed closed medical professional liability claims against ophthalmologists in the United States and found that 24% of claims resulted in payment. Two-thirds were dropped, withdrawn, or dismissed. Cataract and corneal surgeries were the most common claims-related procedures. The average cost associated with liability claims was lower for ophthalmology than for the average of all health specialties combined.
For their study, the authors obtained 10-year data from the Physician Insurers Association of America data-sharing project. They gathered details of claims in ophthalmology and claims for all health specialties, including physician demographics, prevalence rates, associated costs, resolutions, and various medical factors. They also compared data for the first 5 years (2006-2010) and latter 5 years of the study (2011-2015).
During the full 10-year period, 90,743 liability claims were closed, and 24,670 were paid. Of these, only 2.6% of closed claims and 2.2% of all paid claims were against ophthalmologists. Among the ophthalmology claims with a verdict, 90% favored the ophthalmologist. Cataract and corneal surgeries were the most common and costly surgeries in this dataset, accounting for 50% of ophthalmology claims and for $47,641,376 and $32,570,148 (respectively) in total paid indemnity. The average indemnity was higher for corneal procedures ($304,476) than for vitreoretinal procedures ($270,141) or oculoplastic procedures of the eyelid ($222,471) or the orbit and eyeball ($183,467). The chief medical factors prompting claims against ophthalmologists were improper performance, error in diagnosis, and failure to recognize a complication of treatment.
Between the first and second 5-year periods, the prevalence and cost of claims related to endophthalmitis declined: from 38 (3.3%) of 1,160 (average indemnity, $516,875) to 26 (2.2%) of 1,165 (average indemnity, $247,083). The average indemnity paid and amount spent on legal defense was lower for ophthalmologists than for all health specialists combined (indemnity: $280,227 vs. $335,578; legal: $41,450 vs. $46,391).
The original article can be found here.