The Doctors Company’s Obstetrics Closed Claims Study, a review of 882 obstetrical claims that closed from 2007-2014, revealed underlying vulnerabilities that place patients at risk and increase liability for doctors. Obstetricians have the unique risk of caring for two patients at the same time. Mothers and neonates have separate needs and can suffer different injuries.
The most common patient allegation against obstetricians, occurring in 22 percent of claims, was delay in treatment of fetal distress, including failure to act when presented with Category II or III fetal heart rate (FHR) tracings predictive of metabolic acidemia. The study also analyzed the specific factors that contributed to patient injury, and the second-most common factor in these claims (32 percent) was patient assessment issues, including misinterpretation of FHR strips and diagnostic test results.
The following tips to help physicians address these risks have been reviewed by Susan Mann, MD, a board-certified obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
These tips can help address FHR risks:
Here are other steps obstetric professionals can take to reduce the risks identified in this study:
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.