Routine procedures pose significant malpractice risk


The majority (88 percent) of cases in which malpractice is alleged in relation to a non-surgical procedure highlight skill-based errors. However, rules of practice (policy and protocol) and inadequate knowledge or judgment also play a key role, according to a report.

The newly released CRICO Strategies 2013 Annual Benchmarking Report: Malpractice Risks of Routine Medical Procedures analysed 1,497 cases which alleged malpractice related to a non-surgical procedure.

This study—mined from CRICO Strategies Comparative Benchmarking System (CBS)—highlights six primary medical procedures: scopes, injections, punctures, biopsies, insertion of tubes, and imaging. While the very nature of procedure-related claims implies some technical or skill-based failure, the report emphasises that it is critical to understand how rule and judgment-based errors contribute to the actual point of injury.

These medical procedure-related cases were filed from 2007-2011 and represent $215 million in incurred losses. While more than two thirds of the injuries were relatively minor or temporary, 14 percent of the procedure cases involved patients who died.

“In the past, patient safety efforts have focused on inpatient areas, such as the operating room,” said Dr Tejal Gandhi, president of the National Patient Safety Foundation. “Now, however, medical procedures are frequently performed in settings outside of the hospital, with an increased number of adverse events being identified. We need to translate the lessons learned in hospital safety to these other settings of care to ensure that procedures are performed as safely as possible.”

The next hurdle is finding clinical leadership to champion the remediation of such a diffuse problem, said Mark Reynolds, CRICO President.

“Moving the needle on patient safety improvement is hard work,” he said. “In order to get healthcare leaders’ attention, to convince clinicians to carve time out of an already overburdened schedule, to motivate insurance providers to fund solutions, you have to show up with credible evidence that you are tackling the right problems.

“Our CBS database and the surrounding expertise enable CRICO and CRICO Strategies members to be proactive and effective in addressing patient safety over the long term across an entire organization,” he added.

CRICO Strategies is a division of the Risk Management Foundation of the Harvard Medical Institutions, a CRICO company. CRICO Strategies CBS database currently holds 275,000 medical malpractice cases from 500 hospitals and provides a unique insight into what goes wrong, and why.

CRICO, Dr Tejal Gandhi, CRICO Strategies Comparative Benchmarking System, CBS