Medical professional liability risk among US cardiologists.
BACKGROUND
Medical professional liability (MPL) remains a significant burden for physicians, in general, and cardiologists, in particular, as recent research has shown that average MPL defense costs are higher in cardiology than other specialties. Knowledge of the clinical characteristics and outcomes of lawsuits against cardiologists may improve quality of care and risk management.


METHODS
We analyzed closed MPL claims of 40,916 physicians and 781 cardiologists insured by a large nationwide insurer for ≥1 policy year between 1991 and 2005.


RESULTS
The annual percentage of cardiologists facing an MPL claim was 8.6%, compared with 7.4% among physicians overall (P < .01). Among 530 claims, 72 (13.6%) resulted in an indemnity payment, with a median size of $164,988. Mean defense costs for claims resulting in payment were $83,593 (standard deviation (s.d.) $72,901). The time required to close MPL claims was longer for claims with indemnity payment than claims without (29.6 versus 18.9 months; P < .001). More than half of all claims involved a patient's death (304; 57.4%), were based on inpatient care (379; 71.5%), or involved a primary cardiovascular condition (416; 78.4%). Acute coronary syndrome was the most frequent condition (234; 44.2%). Medical professional liability claims involving noncardiovascular conditions were common (66; 12.5%) and included falls or mechanical injuries had while under a cardiologist's care and a failure to diagnose cancer.


CONCLUSIONS
Rates of malpractice lawsuits are higher among cardiologists than physicians overall. A substantial portion of claims are noncardiovascular in nature.
Bassett Heart Care Institute, Cooperstown, NY. Electronic address: sandeep.mangalmurti@bassett.org.
Sandeep
S
Mangalmurti
Department of Emergency Medicine, Keck School of Medicine and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA. Electronic address: seabury@usc.edu.
Seth A
SA
Seabury
John F. Kennedy School of Government, Harvard University, Cambridge, MA. Electronic address: Amitabh_Chandra@harvard.edu.
Amitabh
A
Chandra
Schaeffer Center for Health Policy and Economics, and School of Policy, Planning, and Development, University of Southern California, Los Angeles, CA. Electronic address: dlakdawa@healthpolicy.usc.edu.
Darius
D
Lakdawalla
Division of Science & Quality, American College of Cardiology, Washington, DC. Electronic address: woetgen@acc.org.
William J
WJ
Oetgen
Department of Health Care Policy, Harvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: jena@hcp.med.harvard.edu.
Anupam B
AB
Jena
D002309:Cardiology / Q000191:economics / Q000331:legislation & jurisprudence; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting; D016365:Liability, Legal / Q000191:economics*; D008297:Male; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence*; D010820:Physicians / Q000191:economics / Q000331:legislation & jurisprudence*; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D000078329:Workforce