Abstract: PD32-06
Sources of Funding: None

Introduction

The climate of medical professional liability continues to evolve. Given the resulting impact on practicing urologists, we provide data on urologic malpractice claims, associated costs, and recent trends.

Methods

We analyzed urological provider level medical malpractice claim data from the Physician Insurers Association of America (PIAA). Available data from 2010-2014 were compared to 2005-2009 to investigate recent trends. Monetary data has been adjusted for inflation and is reported in 2014 dollars.

Results

From 2010-2014, 1216 total claims were filed with 27% resulting in an indemnity payment. In comparison to data from 2005-2009, number of total claims increased by 5.5% (1153 claims from 2005-2009), average indemnity payment increased by 1.8% to $360,606, and the average defense expenses increased by 13.3% to $44,339. From 2010-2014, the average indemnity paid for closed urologic claims was 4.1% higher than the combined average for all other 28 medical specialties in the analysis; however, the average defense expenses for closed urologic claims were 13.6% lower. The majority of urological claims were dropped, withdrawn, or dismissed (65.4%), while other common outcomes included settlement (24.3%), a defendant verdict (6.6%), claim settlement via dispute resolution process or contract agreement (2.0%), and plaintiff verdict (0.7%). The most frequent occurrence resulting in a claim was improper performance of a procedure (42%). Calculus of the kidney and ureter (127/1216 claims) was the most prevalent presenting medical condition resulting in a claim followed by malignant neoplasms of the prostate (120 claims) and hyperplasia of the prostate (59 claims). The most common procedures leading to closed claims were operative procedures on the prostate and seminal vesicles (132/1216 claims), operative procedures on the kidney (118 claims), and diagnostic procedures of the bladder (100 claims). Temporary injury was the most frequently claimed patient outcome (308 claims, average indemnity $274,790), while the highest average indemnity paid was for major permanent injury ($676,870).

Conclusions

Urologic claims, indemnity payments and defense expenses continue to increase; however, the majority of claims do not result in indemnity payments. An understanding of claim trends and errors may assist urologists when evaluating risk management strategies and may contribute to improving patient outcomes.

Funding

None