Study Reveals the Most Common Reasons Obstetricians Are Sued

Research Looks into Injuries Suffered During Pregnancy and Delivery

Napa, California—May 1, 2015—Obstetricians have the unique challenge of caring for two patients at the same time—mothers and neonates—and face potential risks during both pregnancy and delivery. A study issued today by The Doctors Company reveals the most common patient allegations against obstetricians and the leading factors that cause injuries during pregnancy and delivery.

The study of 882 obstetrical claims that closed from 2007–2014 revealed that the three most common patient allegations were:

  • Delay in treatment of fetal distress. This was alleged in 22 percent of cases studied. The most common cause of alleged delayed treatment was the physician’s failure to act when presented with Category II or III fetal heart rate tracings, which are predictive of metabolic acidemia.
  • Improper performance of vaginal delivery, alleged in 20 percent of cases studied. Almost half of these cases involved brachial plexus injuries due to shoulder dystocia.
  • Improper management of pregnancy, alleged in 17 percent of cases. These cases included failure to test for fetal abnormalities when indicated, failure to recognize complications of pregnancy, and failure to address abnormal findings.

The remainder of the cases studied included diagnosis-related claims and allegations of delay in delivery, improper performance of operative delivery, retained foreign bodies, and improper choice of delivery method.

“As the nation’s largest physician-owned medical malpractice insurer, The Doctors Company has the largest database of malpractice claims,” said David B. Troxel, MD, medical director, The Doctors Company. “We are pleased to be able to share this data, which is clearly representative of the risks that obstetricians face when caring for mothers and during delivery.”

When malpractice suits are filed, practicing physicians are recruited by The Doctors Company to review the cases to look beyond what the patient is alleging and to determine the factors that led to the injuries.

“Understanding the causes of these allegations is a very important first step in a process whereby interventions can then be developed to address these system failures and improve the safety of care for our patients,” said Susan Mann, MD, a board-certified obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

In the case of obstetrics claims, the panel of experts found the following top seven factors, with more than one factor often contributing to each injury:

  • Selection and management of therapy. Issues included decisions regarding labor and delivery, such as augmentation of labor, methods of delivery, and timing of interventions. (34%)
  • Patient assessment issues. Physicians were found to disregard available test results or documented findings in the patient record. (32%)
  • Technical performance. This included injuries that were related to known risks that had been disclosed to patients. (18%)
  • Communication among providers, such as failure to keep other providers updated on a patient’s condition. This may have been related to poor professional relationships. (17%)
  • Patient factors, such as nonadherence by patients to their treatment plans for such conditions as diabetes or preeclampsia. (16%)
  • Insufficient or lack of documentation of such things as clinical findings or review of care. (14%)
  • Communication between patient/family and provider. This may have been caused by poor rapport between the physician and the patient or language barriers, and it often led to patient noncompliance with physician instructions. (14%)

About The Doctors Company
Founded and led by physicians, The Doctors Company ( 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 76,000 members and $4.5 billion in assets, and is rated A by A.M. Best Company and Fitch Ratings.

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