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  • 10-Year Review of Liability Claims in Ophthalmology

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD
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    Journal Highlights

    Ophthalmology, May 2018

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    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 Two-thirds were dropped, withdrawn, or dismissed.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.