General Surgery

Professional Education
Errors in Anticoagulation Management in the Dermatology Office (Claims Corner CME)
In reviewing closed malpractice claims, The Doctors Company has found an increased risk of claims in patients taking direct acting oral anticoagulants that undergo office-based dermatologic procedures. This case study highlights the factors contributing to the improper management of these patients, including errors in clinical judgment, anticoagulant management, and communication.
0.5 credit

Professional Education
Anesthesia Care Preventing Dental Injury
Dental injury claims continue to make up almost a quarter of all anesthesiology claims (22 percent) with over 30 percent of tooth damage claims resulting in indemnity payments to the plaintiff. Due to the frequent occurrence of dental injury claims, anesthesia professionals must be aware of dental injury causes, preventive measures, and steps to take if injury occurs.
0.8 credit

Oct 24, 2022
Why Medical Clearance Is Really a Preoperative Evaluation
Debra Davidson, MJ, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company, and David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
The goals of the preoperative evaluation are to determine the patient's level of risk and to identify opportunities to mitigate it.

Oct 18, 2022
Moderate or Conscious Sedation in the Office Setting
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.

Oct 04, 2022
Mapping the Perioperative Claims Experience of General Surgeons
Jacqueline Ross, RN, PhD; Kim Hathaway, RN, MSN; Melissa Nelson, RN, BSN; Kathrine Soulsby, RN, BSN; Angela Jordan, RN, MHSc
About 63 percent of general surgeons have been involved in a medical malpractice suit. Understanding the most common types of complications and the factors that contribute to errors may provide insights for general surgeons about their practice.

Jun 17, 2022
As Telemedicine Best Practices Emerge, Assess Your Practice
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors
Healthcare leaders have discovered that remote care reveals some unexpected advantages.
From The Doctor’s Advocate

Oct 26, 2021
Identifying Malpractice Risks for Surgical Practices
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, The Doctors Company
Factors contributing to surgical claims are often related to assessment, communication, and documentation. Surgeons can improve outcomes by evaluating their supporting systems in the office and the locations where they operate.

Oct 20, 2021
Diagnostic Error in General Surgery: Cognitive Bias and Systems Issues in Medical Malpractice Claims (Abstract)
Jacqueline Ross, RN, PhD, Coding Director, Department of Patient Safety and Risk Management
Although claims against general surgeons primarily allege technical surgical-type errors, diagnostic error is the second most frequent allegation against or case type for general surgeons. Analysis of malpractice claims can elucidate the causes of and solutions to diagnostic errors. This study considers differences between diagnostic errors, both cognitive and systemic, committed by general surgeons in the inpatient vs. the outpatient setting.

Sep 29, 2021
Getting Sued for Breast Cancer Malpractice
Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group
Our closed claims data reveal that suits involving breast cancer are the most common type of cancer-related claim. This article lists the issues that most often lead to claims.

Professional Education
Pathologists and Surgeons Can Collaborate to Reduce Diagnostic Error
The Doctors Company has updated the claims filed against pathologists between the years 2015 and 2020. The information provides quantitative and qualitative data that a pathologist and surgeon would find meaningful in reducing diagnostic error. This program provides a breakdown of where patient injuries occur involving pathologists and surgeons and how collaboration between the two disciplines can improve patient outcomes.
1.0 credit

Professional Education
Breast Cancer Claims – A Review in Gynecology
Breast cancer medical negligence claims are reviewed over a ten-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Apr 02, 2021
Pre-Procedural Screening and Testing During COVID-19
Throughout the pandemic, surgeons have faced many challenges in adapting to new situations. Now that facilities have resumed elective surgeries, surgeons are facing additional challenges in evaluating and scheduling patients who have recovered from COVID-19. The strategies highlighted here can help ensure a consistent approach in keeping both patients and providers safe.

Mar 24, 2021
Patient Selection for Elective Cosmetic Procedures
James E. Vogel, MD, FACS, Associate Professor of Plastic Surgery, The Johns Hopkins Hospital and School of Medicine, and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education, The Doctors Company
The patient selection process is a valuable tool that can help you reduce risks when you assess prospective patients for elective cosmetic procedures.

Mar 23, 2021
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Roneet Lev, MD, Chief of Scripps Mercy Emergency Department, Chair of Prescription Drug Abuse Medical Task Force, and President of Independent Emergency Physicians Consortium
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

Feb 26, 2021
Resources for Elective Procedures During COVID-19
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Julie Ritzman, MBA, CPHRM, Vice President, Department of Patient Safety and Risk Management
Your patients most likely want to know about the safety of surgery during the pandemic and what occurs if they contract COVID-19 post-procedure. You may have questions about keeping your staff and patients safe, informing patients about new risks the pandemic has created, and potential liability risks you may be facing.

Professional Education
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
1.5 credits

Jan 26, 2021
Laparoscopic Lysis of Adhesions Leads to Missed Bowel Perforation: Case Study
David B. Troxel, MD, Medical Consultant to The Doctors Company
Experts opine on the case of a patient who suffered a bowel injury during laparoscopic surgery. The discussion includes strategies for recognizing patients who might be at increased risk.

Professional Education
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
0.5 credit

Professional Education
Lessons Learned – Plastic Surgery Closed Claims Study: An Expert Analysis of Medical Malpractice Allegations
This course is based on the findings of a study conducted by The Doctors Company that analyzed 415 claims that closed against plastic surgeons (from July 2015–December 2018).
1.3 credits

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Jun 15, 2020
Safely Caring for the Hospitalized Patient with Obesity
Paul Nagle, ARM, CPHRM, Director, Department of Patient Safety and Risk Management, and Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management
Obesity is viewed as a chronic health condition, and patients with obesity pose patient safety issues.

Dec 12, 2019
Making Further Advancements in Anesthesia Care Safety
Susan K. Palmer, MD; Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management; and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
We analyzed 459 claims for new trends in anesthesia care.
From The Doctor’s Advocate

Sep 05, 2019
Advanced Practice Provider Closed Claims: What Can We Learn?
Howard Marcus, MD, FACP, and Susan Shepard, MSN, RN, Senior Director, Patient Safety Staff Education
Top allegations in our claims analysis involving advanced practice providers centered on diagnosis.
From The Doctor’s Advocate

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

Jun 13, 2019
An Analysis of Malpractice Claims by Physician Gender
David B. Troxel, MD, Medical Consultant to The Doctors Company
A gender-specific analysis of 5,897 claims from six medical specialties.
From The Doctor’s Advocate

Mar 20, 2019
Study of Malpractice Claims Involving Children
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.