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Anesthesia malpractice closed claims

Darrell Ranum, Anair Beverly, Fred E Shapiro, Richard D Urman
OBJECTIVE: We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). METHODS: We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value...
November 16, 2017: Journal of Patient Safety
Zachary G Woodward, Richard D Urman, Karen B Domino
Malpractice claims for non-operating room anesthesia care (NORA) had a higher proportion of claims for death than claims in operating rooms (ORs). NORA claims most frequently involved monitored anesthesia care. Inadequate oxygenation/ventilation was responsible for one-third of NORA claims, often judged probably preventable by better monitoring. Fewer malpractice claims for NORA occurred than for OR anesthesia as assessed by the relative numbers of in NORA versus OR procedures. The proportion of claims in cardiology and radiology NORA locations were increased compared with estimates of cases in these locations...
December 2017: Anesthesiology Clinics
Richard C Prielipp, Julia L Weinkauf, Thomas M Esser, Brian J Thomas, Mark A Warner
Patient safety secured by constant vigilance remains a primary responsibility of every anesthesia professional. Although significant attention has been focused on patient falls occurring before and after surgery, a potentially catastrophic complication is when patients fall off an operating room or procedure table during anesthesia care. Because such events are (fortunately) uncommon, and because very little information is published in our literature, we queried 2 independent closed claims databases (the American Society of Anesthesiologists Closed Claims Project and the secure records of a private, anesthesia specialty-specific liability insurer) for information...
September 2017: Anesthesia and Analgesia
Christian M Schulz, Amanda Burden, Karen L Posner, Shawn L Mincer, Randolph Steadman, Klaus J Wagner, Karen B Domino
BACKGROUND: Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. METHODS: Surgical and procedural anesthesia death and brain damage claims in the Anesthesia Closed Claims Project database were analyzed. Situational awareness error was defined as failure to perceive relevant clinical information, failure to comprehend the meaning of available information, or failure to project, anticipate, or plan...
August 2017: Anesthesiology
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
December 2017: Clinical Orthopaedics and related Research
Marzieh R Honardar, Karen L Posner, Karen B Domino
This retrospective case series analyzed 45 malpractice claims for delayed detection of esophageal intubation from the Anesthesia Closed Claims Project. Inclusion criteria were cases from 1995 to 2013, after adoption of identification of CO2 in expired gas to verify correct endotracheal tube position as a monitoring standard by the American Society of Anesthesiologists. Forty-nine percent (95% confidence interval 34%-64%) occurred in the operating room or other anesthesia location where CO2 detection equipment should have been available...
February 15, 2017: Anesthesia and Analgesia
Bryan A Wilbanks, Marjorie Geisz-Everson, Rebecca R Boust
Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions...
September 2016: Computers, Informatics, Nursing: CIN
Lorraine M Jordan, Jihan A Quraishi
The AANA Foundation Closed Claims Researchers evaluated 245 closed claims spanning from 2003-2012. The majority of claims comprised CRNA providers whom are mainly male, independent contractors, certified between 1980-1999, and with malpractice coverage limits of $1 million/$3 million. The median age for all claimants was 50 years old, and 63.7% of claimants were female. For those claims where race was known, 54% of claimants were Caucasian. Most adverse events occurred in a hospital with an outpatient admission status...
October 2015: AANA Journal
Kelly A Pollak, Linda S Stephens, Karen L Posner, James P Rathmell, Dermot R Fitzgibbon, Richard P Dutton, Edward Michna, Karen B Domino
BACKGROUND: The authors examined changes in the frequency of pain medicine malpractice claims and associated treatment modalities and outcomes over time. METHODS: The authors analyzed trends in pain medicine claims from 1980 to 2012 in the Anesthesia Closed Claims Project database by binary logistic regression on year of event. Pain procedures in claims from 2000 to 2012 were compared with the proportion of pain procedures reported to the National Anesthesia Clinical Outcomes Registry in 2010-2014...
November 2015: Anesthesiology
Umberto Genovese, Alberto Blandino, Riccardo Midolo, Michelangelo B Casali
BACKGROUND: Medical malpractice is currently a crucial topic and anesthesia is a key specialty for the improvement of patient safety. However, death and permanent impairment due to anesthesia still occur and studies of insurance analysis data are increasing. We investigated the main features of a major Italian insurance broker's archive in order to identify possible recurrent pitfalls in this critical field of medicine. METHODS: Three hundred seventeen Italian claims were analyzed, filling out a standardized form that recorded information on patient and physician's characteristics, procedures, sequence and location of events and outcomes...
February 2016: Minerva Anestesiologica
Lorri A Lee, Robert A Caplan, Linda S Stephens, Karen L Posner, Gregory W Terman, Terri Voepel-Lewis, Karen B Domino
BACKGROUND: Postoperative opioid-induced respiratory depression (RD) is a significant cause of death and brain damage in the perioperative period. The authors examined anesthesia closed malpractice claims associated with RD to determine whether patterns of injuries could guide preventative strategies. METHODS: From the Anesthesia Closed Claims Project database of 9,799 claims, three authors reviewed 357 acute pain claims that occurred between 1990 and 2009 for the likelihood of RD using literature-based criteria...
March 2015: Anesthesiology
Darrell Ranum, Haobo Ma, Fred E Shapiro, Beverly Chang, Richard D Urman
INTRODUCTION: The analysis of malpractice claims can provide risk managers with a detailed view of patient mortality and morbidity. The data comes from many institutions, encompasses a diverse group of practitioners and practice settings, and contains detailed clinical information. Analysis can help identify patterns of injury, risk factors, and rare and sentinel events. METHODS: We examined most recent anesthesia closed claims data collected by The Doctors Company, a large national malpractice insurer...
2014: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
Richard P Dutton, Lorri A Lee, Linda S Stephens, Karen L Posner, Joanna M Davies, Karen B Domino
BACKGROUND: Hemorrhage is a potentially preventable cause of adverse outcomes in surgical and obstetric patients. New understanding of the pathophysiology of hemorrhagic shock, including development of coagulopathy, has led to evolution of recommendations for treatment. However, no recent study has examined the legal outcomes of these claims. The authors reviewed closed anesthesia malpractice claims related to hemorrhage, seeking common factors to guide future management strategies. METHODS: The authors analyzed 3,211 closed surgical or obstetric anesthesia malpractice claims from 1995 to 2011 in the Anesthesia Closed Claims Project...
September 2014: Anesthesiology
Bryan G Maxwell, Karen L Posner, Jim K Wong, Daryl A Oakes, Nate E Kelly, Karen B Domino, Chandra Ramamoorthy
OBJECTIVE: Prior investigations have suggested that the rapidly growing population of adults with congenital heart disease is at increased risk of perioperative morbidity and mortality, but information is limited on the nature of those perioperative factors that may relate to adverse outcomes. We sought to use a national claims database to describe the contribution of perioperative factors to adverse outcomes and compare contributing factors in cardiac vs. noncardiac operations. DESIGN: The study is a retrospective in-depth structured analysis of cases from the Anesthesia Closed Claims Project database...
January 2015: Congenital Heart Disease
Sonya P Mehta, Sanjay M Bhananker, Karen L Posner, Karen B Domino
BACKGROUND: To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. METHODS: All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. RESULTS: There were 103 OR fire claims (1...
May 2013: Anesthesiology
M T Pitkänen, U Aromaa, D A Cozanitis, J G Förster
BACKGROUND: Analyses of closed claims provide insight into the characteristics of rare complications. Serious complications related to spinal and epidural blocks are relatively rare. In Finland, all malpractice cases are primarily handled by the Patient Insurance Centre (PIC) within a 'no-fault scheme'. METHODS: All claims attributed to central neuraxial blocks and settled by the PIC during the period, 2000-2009 were analysed. The number of spinal and epidural procedures performed during this time was estimated based on a questionnaire sent to all surgical hospitals in Finland in 2009, surveying the numbers and types of neuraxial blocks carried out in 2008...
May 2013: Acta Anaesthesiologica Scandinavica
Julia Metzner, Christopher D Kent
PURPOSE OF REVIEW: To summarize the currently available data on malpractice claims related to ambulatory anesthesia and provide an insight into the emerging patterns of anesthesia liability in this practice setting. RECENT FINDINGS: At present, studies are mixed about how the continued growth of outpatient surgery will impact liability for anesthesiologists. Data derived from the ASA Closed Claims Project suggests that malpractice claims for major damaging events are less common in the outpatient settings than in inpatient settings...
December 2012: Current Opinion in Anaesthesiology
Hernando Olivar, Sam R Sharar, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Trauma care has many challenges, including the perception by nonanesthesia physicians of increased medical malpractice liability. We used the American Society of Anesthesiologists' Closed Claims Project database and the National Inpatient Sample (NIS) to compare the rate of claims for trauma anesthesia care to national trauma surgery data. We also used the American Society of Anesthesiologists' Closed Claims Project database to evaluate injury and liability profiles of trauma anesthesia malpractice claims compared to nontrauma surgical anesthesia claims...
November 2012: Anesthesia and Analgesia
Maggie C Chicka, Jeffrey B Dembo, Kavita R Mathu-Muju, David A Nash, Heather M Bush
PURPOSE: The purpose of this study of closed malpractice insurance claims was to provide descriptive data of adverse events related to child sedation and anesthesia in the dental office. METHODS: The malpractice claims databases of two professional liability carriers were searched using pre-determined keywords for all closed claims involving anesthesia in pediatric dental patients from 1993-2007. RESULTS: The database searches resulted in 17 claims dealing with adverse anesthesia events of which 13 involved sedation, 3 involved local anesthesia alone, and 1 involved general anesthesia...
May 2012: Pediatric Dentistry
Steven E Pegalis, B Sonny Bal
BACKGROUND: Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. QUESTIONS/PURPOSES: We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols...
May 2012: Clinical Orthopaedics and related Research
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