title: Malpractice claims against emergency physicians in Massachusetts: 1975-1993.
abstract: This study reviewed 549 malpractice claims filed against emergency physicians in Massachusetts from 1975 through 1993, with a total of $39,168,891 of indemnity and expense spent on the 549 closed claims. High-risk diagnostic categories (chest pain, abdominal pain, wounds, fractures, pediatric fever/meningitis, epiglottitis, central nervous system bleeding, and abdominal aortic aneurysm) accounted for 63.75% of all closed claims and 64.23% of the total indemnity and expense spent on closed claims. Missed myocardial infarction (chest pain) claims accounted for 25.47% of the total cost of closed claims but only 10.38% of closed claims. The number of claims for missed myocardial infarction increased in the post-1988 closed claim group compared to the pre-1988 group; fractures and wounds were significantly less frequent in the post-1988 group. The frequency of high-risk claims decreased in the post-1988 group, largely because of the decline in fracture and wound claims. The category of missed myocardial infarction had a larger percentage of claims closed with indemnity payment than without indemnity payment. This parameter may serve as a marker for the overall seriousness of claims associated with a particular allegation, unlike the average cost per claim, which may be skewed by a few large awards.
authors.affiliation: Healthcare Opportunities, Inc. Watertown, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Karcz
authors.forename: R
authors.initials: R
authors.lastname: Korn
authors.forename: M C
authors.initials: MC
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Caggiano
authors.forename: M J
authors.initials: MJ
authors.lastname: Doyle
authors.forename: M J
authors.initials: MJ
authors.lastname: Erdos
authors.forename: E D
authors.initials: ED
authors.lastname: Green
authors.forename: K
authors.initials: K
authors.lastname: Williams
mesh_terms: D003951:Diagnostic Errors; D004635:Emergency Medicine / Q000331:legislation & jurisprudence*; D006801:Humans; D007345:Insurance Claim Review; D008318:Malpractice / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D008404:Massachusetts; D009203:Myocardial Infarction / Q000175:diagnosis