title: Outcomes of medical malpractice claims in assisted reproductive technology over a 10-year period from a single carrier.
abstract: OBJECTIVE
  Medical malpractice claims vary by specialty. Contributory factors to malpractice in reproductive endocrinology and infertility (REI) are not well defined. We sought to determine claims' frequency, basis of claims, and outcomes of settled claims in REI.
  
  
  METHODS
  This is a retrospective, descriptive review of 10 years of claims.
  
  
  METHODS
  The setting is private practices.
  
  
  METHODS
  Claims were monitored within one malpractice carrier between 2006 and 2015 covering 10 practices and 184,015 IVF cycles. Total claims, basis of claims, and indemnity paid were evaluated.
  
  
  RESULTS
  There were 176 incidents resulting in 30 settled claims with indemnity payments in 21. Categories of claims settled included misdiagnosis (N = 4), lack of informed consent (N = 5), embryology errors (N = 8), and surgical complications (N = 4). Total and average awards were $15,062,000 and $717,238, respectively. Misdiagnosis and lack of informed consent had highest total award amount at $11,583,000 accounting for 76% of award dollars. The two highest awards were $4.5 million and $3.0 million for cancer and genetic misdiagnosis, respectively. Excluding these two awards, payments totaled $7,562,000, ranged from $6000 to $900,000 and averaged $170,363. Errors in handling of embryos were highest in frequency accounting for 38% of claims paid for a total of $1,593,000 with average payment of $199,188. Settlements for surgical complications totaled $1,855,000 and averaged $463,750 per claim.
  
  
  CONCLUSIONS
  Misdiagnosis and lack of informed consent are the highest award categories. Embryology lab errors are the most frequent causes of claims with the lowest award per settlement. The average cost for claims settled is relatively high compared to settlements in other specialties.
authors.affiliation: Seattle Reproductive Medicine, 1505 Westlake Suite 400, Seattle, WA, 981105, USA. gerard.letterie@integramed.com.
authors.forename: Gerard
authors.identifier: http://orcid.org/0000-0001-9447-3295
authors.initials: G
authors.lastname: Letterie
mesh_terms: D003951:Diagnostic Errors / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting / Q000331:legislation & jurisprudence*; D008318:Malpractice / Q000331:legislation & jurisprudence*; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000331:legislation & jurisprudence*
keywords: Claim settlements; Medical error; Medical malpractice; Misdiagnosis