Study Reveals Underlying Vulnerabilities in the Practice of Cardiology

Factors that Contribute to Patient Injury Analyzed by Panel of Experts

Napa, California—February 2, 2015—Diagnostic-related issues are the main reason cardiologists are sued and the top cause of patient injury, according to a study issued today by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer.

The study of 429 cardiology claims that closed from 2007–2013 showed that the most common allegation made by patients was diagnosis-related. In 25 percent of claims, patients alleged failure to diagnose, delay in diagnosis, or wrong diagnosis. Other common patient allegations detailed in the study are:

  • Improper management of treatment, such as cardiac arrest during intervention for cardiac tamponade. (14 percent)
  • Improper performance of treatment or procedure. Examples of claims included hematomas and retroperitoneal bleeding. (12 percent)
  • Improper performance of surgery, such as arterial injury during mitral valve repair. (11 percent)
  • Improper medication management, such as improperly monitoring and managing anticoagulants, leading to stroke. (6 percent)

The top patient allegation was similar to the findings of expert physician reviewers, who looked into the top factors contributing to patient injury in these claims. The experts identified patient assessment issues, including failure to establish a differential diagnosis, as the number-one factor. Patient assessment issues contributed to injury in 25 percent of cases. More than one factor can contribute to a patient injury, with other factors identified as:

  • Technical performance, with most issues related to known complications discussed with the patient prior to the procedure. (21 percent)
  • Patient factors, such as nonadherence with the treatment plan. (20 percent)
  • Selection and management of therapy, such as inappropriate surgical or other invasive procedure. (18 percent)
  • Communication among providers, including failure to review the medical record. (15 percent)
  • Communication between patient/family and provider, including poor follow-up instructions. (14 percent)

“This analysis of closed claim data by The Doctors Company allows us to identify particular scenarios that cardiologists face,” said Sandeep Mangalmurti, MD, JD, cardiologist at Bassett Heart Care Institute in Cooperstown, New York. “Understanding the clinical details of these lawsuits may help cardiologists avoid them completely, or minimize their effects. This study applies to other practitioners as well, by providing insights on specific behaviors and clinical scenarios that they should avoid to lessen their liability risks.”

“This study is unique from other analyses of malpractice claims because our panel of expert physicians was able to analyze each individual claim to determine what led to patient injury,” said David B. Troxel, MD, medical director, The Doctors Company. “With our unparalleled knowledge of liability claims against cardiologists, we are able to anticipate emerging trends and help physicians reduce risks and promote patient safety. Providing studies on our claims data contributes to our mission to advance the practice of good medicine.”

View the study at www.thedoctors.com/cardiologystudy.

About The Doctors Company
Founded and led by physicians, The Doctors Company (www.thedoctors.com) is relentlessly committed to advancing, protecting, and rewarding the practice of good medicine. The Doctors Company is the nation’s largest physician-owned medical malpractice insurer, with 75,000 members and $4.3 billion in assets, and is rated A by A.M. Best Company and Fitch Ratings.

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