title: A comparison of obstetric and nonobstetric anesthesia malpractice claims.
abstract: Malpractice claims filed against anesthesiologists for care involving obstetric (OB) anesthesia (n = 190) were taken from the American Society of Anesthesiologists' Closed Claims Database and compared to claims not involving OB cases (n = 1351). The most common complications in the OB claims were (percentage of all OB claims): maternal death (22%), newborn brain damage (20%), and headache (12%). In contrast, the most common complications in the nonobstetric (non-OB) group were (percentage of all non-OB claims): death (39%), nerve damage (16%), and brain damage (13%). The group of OB claims contained a proportionately greater number of minor injuries, such as headache, backache, pain during anesthesia, and emotional injury (32%) compared to the non-OB claims (4%). Complications due to aspiration and convulsions were more common among the OB cases. The standard of care was judged to have been met in 46% of OB and 39% of non-OB claims. This difference is not statistically significant. Claims involving general anesthesia were more frequently associated with severe injuries and resulted in higher payments than did claims involving regional anesthesia. Payments were made in a similar proportion of OB and non-OB claims (53 and 59%, respectively). For cases in which payments were made, the median payment for OB claims was significantly greater ($203,000) than for non-OB claims ($85,000; P less than or equal to 0.05).
authors.affiliation: Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
authors.forename: H S
authors.initials: HS
authors.lastname: Chadwick
authors.forename: K
authors.initials: K
authors.lastname: Posner
authors.forename: R A
authors.initials: RA
authors.lastname: Caplan
authors.forename: R J
authors.initials: RJ
authors.lastname: Ward
authors.forename: F W
authors.initials: FW
authors.lastname: Cheney
mesh_terms: D000328:Adult; D000761:Anesthesia Department, Hospital / Q000331:legislation & jurisprudence*; D000765:Anesthesia, Conduction / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D003625:Data Collection; D005260:Female; D006801:Humans; D007351:Insurance, Liability / Q000706:statistics & numerical data*; D008318:Malpractice / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D014481:United States