This presentation features a compilation of national medical malpractice claim data from 2006 to 2015. It highlights the three most prevalent chief medical factors and patient outcomes by specialty.

1. WHAT EVERY PHYSICIAN
NEEDS TO KNOW:
MEDICAL MALPRACTICE
CLAIM TRENDS

2. MEDICAL
MALPRACTICE
DATA SOURCE
This is a compilation of
national medical malpractice
claim data from January 1,
2006 to December 31, 2015.
The data is submitted by member
companies of the Medical
Professional Liability Association
(MPL Association), an association
of liability insurance companies
formerly known as PIAA.
2

3. MPL ASSOCIATION
The MPL Association’s member companies insure more than
two-thirds of private practicing physicians in the United
States.
All data is reported in a codified manner; the names of
physicians are not reported.
3

4. ABOUT THE DATA
The following data highlights the three most prevalent chief medical
factors and patient outcomes by specialty.
4

5. DEFINITIONS
According to the MPL Association:
• “chief medical factor” is an “act, or omission by a health
care provider that falls below the accepted standards of
medical care, triggering a claim for medical and/or legal
damages”
• “outcome” is the patient’s condition that “occurred after a
medical encounter and resulted in the chief medical factor”
5

6. DEFINITIONS
The following term is used throughout this presentation.
• “no medical misadventure” is a “code used in the absence of
a medical mishap. If a claim has no medical misadventure, but
is felt to have legal merit, there is an appropriate associated
issue designated in the database. These can be problems with
records, consent issues, laboratory issues or even assault/
battery, abandonment, etc..”
6

7. Top chief medical factors (most prevalent):
1. No medical misadventure
2. Improper performance
3. Problems with patient monitoring in surgery
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Central nervous system complications of a procedure
3. Broken tooth
ANESTHESIOLOGY
7

8. CARDIOVASCULAR AND
THORACIC SURGERY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Failure to recognize a complication of treatment
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Surgical foreign body left in patient during a procedure
3. Accidental puncture or laceration during a procedure
8

9. CARDIOVASCULAR
DISEASES – NONSURGICAL
Top chief medical factors (most prevalent):
1. Improper performance
2. Errors in diagnosis
3. Performed when not indicated or contraindicated
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Long term use of drugs
3. Acute myocardial infarction
9

10. DERMATOLOGY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Dyschromia (alteration of skin or nail color)
2. Malignant neoplasms of the skin
3. Malignant melanoma
10

11. Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Acute myocardial infarction
3. Occlusion and stenosis of cerebral arteries
EMERGENCY MEDICINE
11

12. GASTROENTEROLOGY
Top chief medical factors (most prevalent):
1. Improper performance
2. Errors in diagnosis
3. No medical misadventure
Top outcomes (most prevalent):
1. Accidental puncture or laceration during a procedure
2. Cardiac or cardiorespiratory arrest
3. Disorder of intestine
12

13. GENERAL AND FAMILY
PRACTICE
Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Acute myocardial infarction
3. Emotional distress only
13

14. GENERAL SURGERY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Postoperative infection
3. Accidental puncture or laceration during a procedure
14

15. Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Accidental puncture or laceration during a procedure
2. Emotional distress only
3. Surgical foreign body left in patient during a procedure
GYNECOLOGY
15

16. INTERNAL MEDICINE
Top chief medical factors (most prevalent):
1. No medical misadventure
2. Errors in diagnosis
3. Improper performance
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Acute myocardial infarction
3. Lung cancer
16

17. NEUROLOGY -
NONSURGICAL
Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Occlusion and stenosis of cerebral arteries
2. Encephalopathy, not further defined
3. Cerebrovascular accident
17

18. NEUROSURGERY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Central nervous system complications of a procedure
2. Specified complications of procedures
3. Postoperative infection
18

19. Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Brain damaged infant
2. Birth trauma
3. Surgical foreign body left in patient during a procedure
OBSTETRIC AND
GYNECOLOGIC SURGERY
19

20. OPHTHALMOLOGY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Moderate to severe visual impairment
2. Retinal detachments and defects
3. Specified visual disturbances, other
20

21. ORTHOPEDIC SURGERY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Postoperative infection
2. Specified complications of procedures
3. Disorder of joint, not including arthritis
21

22. OTORHINOLARYNGOLOGY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Unhappy with results of plastic surgery
2. Cardiac or cardiorespiratory arrest
3. Hearing impairment or loss
22

23. Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Unnecessary procedure performed
2. Malignant neoplasm of the female breast
3. Emotional distress only
PATHOLOGY
23

24. PEDIATRICS
Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Cardiac or cardiorespiratory arrest
2. Brain damaged infant
3. Emotional distress only
24

25. PLASTIC SURGERY
Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Failure to recognize a complication of treatment
Top outcomes (most prevalent):
1. Unhappy with the results of plastic surgery
2. Postoperative infection
3. Dyschromia (alteration of skin or nail color)
25

26. RADIOLOGY
Top chief medical factors (most prevalent):
1. Errors in diagnosis
2. No medical misadventure
3. Improper performance
Top outcomes (most prevalent):
1. Malignant neoplasms of the female breast
2. Malignant neoplasms of the bronchus and lung
3. Cardiac or cardiorespiratory arrest
26

27. Top chief medical factors (most prevalent):
1. Improper performance
2. No medical misadventure
3. Errors in diagnosis
Top outcomes (most prevalent):
1. Malignant neoplasms of the prostate
2. Foreign body left in patient during surgical procedure
3. Accidental puncture or laceration during a procedure
UROLOGIC SURGERY
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28. MORE INFORMATION
“Claims by Specialty: MPL Association’s 2006-2015 National Closed
Claim Data” in TMLT’s publication the Reporter, Q4 (2018).
Access at https://hub.tmlt.org/reporter/reporter-q4-2018.
*Reprinted with permission from the MPL Association, formerly PIAA.
MPL Closed Claim Comparative, 2016 Edition, PIAA. Copyright, 2016
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29. PROTECTION FOR A
NEW ERA OF MEDICINE
ABOUT TMLT:
With more than 20,000 health care professionals in its care, Texas Medical
Liability Trust (TMLT) provides malpractice insurance and related products
to physicians. Our purpose is to make a positive impact on the quality of
health care for patients by educating, protecting, and defending physicians.
www.tmlt.org
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