Rates of malpractice lawsuits in cardiology have followed a slow upward trajectory for the past decade and are continuing to climb, according to a review of more than 1,500 liability claims published in the American Journal of Cardiology this week.
Frances Wang, MS, and Sandeep K. Krishnan, MD, conducted an analysis of 1,538 cardiology malpractice claims filed between 2006 and 2015 in an effort to characterize current malpractice trends and common sources of patient injury in the field. With the rise of “defensive medicine”—the idea that physicians treat their patients to avoid liability suits rather than provide the most beneficial care—the authors said the quality of healthcare in the U.S. is declining.
Wang and Krishnan said defensive medicine is likely a driver behind the steady growth in average physician malpractice payments in recent years, which has followed the national trend of rising healthcare costs.
“With increasing healthcare costs and the high cost of spending driven by defensive medicine, shedding light on recent litigation trends is critical for understanding current tort patterns, especially in the field of cardiology, a specialty with higher rates of malpractice suits than average,” the authors wrote in AJC. “Understanding the characteristics of these liability claims and common types of patient injuries can aid cardiologists in mitigating malpractice risk and better patient care.”
The researchers drew from the CBS (Controlled Risk Insurance Company’s Comparative Benchmarking Systems) database, which comprises more than 350,000 medical malpractice cases—a subset of more than 40 percent of medical claims in the country. The database represents more than 177,500 physicians.
Wang and Krishnan found both the total number of claims and annual indemnity payments in cardiology increased between 2006 and 2015, with raw counts of cardiology claims increasing by 91 percent over the study period and total liability paid growing by 142 percent.
“In analyzing medical malpractice rates from the CBS database, current concerns of increasing trends in litigation claims and malpractice costs seem well-founded,” the authors said.
Of the hundreds of claims, the leading allegations for malpractice were improper medical treatment and diagnostic errors, the latter of which accounted for around one-fifth of closed claims. Indemnity paid in improper medical treatment cases alone totaled $110 million in the 10-year study period.
Other trends among claims included miscommunication, safety and monitoring issues and equipment malfunction.
Though their sample case size was large, Wang and Krishnan wrote the majority (68 percent) of cardiology claims filed during their research were either decreased, denied or dismissed. Thirty percent of the remaining 32 percent were settled outside of court.
The authors said their research might help improve physicians' understanding of how to avoid common sources of patient injury, decrease their risk of liability and guide liability and safety reform in hospitals.
“These estimates for cardiovascular litigation trends, allegations and outcomes provide a glimpse into the characteristics of medical malpractice claims from 2006 to 2015,” they wrote. “These data can be used to contextualize the discussion for tort reform in an environment of growing defensive medicine practices and exponentially increasing costs of healthcare.”