Obstetrics and Gynecology

Jan 05, 2023
Five Key Concerns of Medical Professionals Post-Roe
In the wake of the Supreme Court ruling in Dobbs v. Jackson, which overturned Roe v. Wade, state restrictions are colliding with clinical judgment in ways unfamiliar to many medical professionals. Physicians and other healthcare providers are facing confusion and concern about how recent legal shifts affect them and their patients.

Dec 15, 2022
The Clinician Voice Post-Roe: Speaking Up for Standards of Care
The spillover effects of the Supreme Court’s Dobbs decision, which overturned Roe v. Wade, mean that many clinicians face uncertainty regarding which treatment practices are still legal in their state. Accordingly, they may be unsure how to communicate with patients, or uncertain regarding their role in their institution’s planning conversations.

Dec 13, 2022
Increased Risks of Delayed Care Post-Roe: Clinician Perspectives
In the wake of the Dobbs decision, which overturned Roe v. Wade, rapid changes in hospital protocols have at times amplified confusion over what is legally allowed when responding to ectopic pregnancy, miscarriage, or other obstetric complications. Clinicians in some states may feel pinned between their obligation to care for the patient and their obligation not to break the law.

Dec 09, 2022
Training Shortages Post-Roe: Medical Careers, Accreditation, and Patient Safety at Risk
The short-term disruptions faced by many medical professionals in the wake of the Dobbs decision, which overturned Roe v. Wade, have partially obscured a looming crisis in access to training.

Video Nov 18, 2022
Treating Medical Emergencies in the Post-Roe Landscape
Ghazaleh Moayedi, DO, MPH, of Pegasus Health Justice Center, explains the challenges OB/GYNs face treating medical emergencies in the complex legal landscape following the overturning of Roe v. Wade.

Video Nov 18, 2022
What Challenges Will Healthcare Professionals Face Following the Overturn of Roe v. Wade?
Sheila Dejbakhsh, MD, MPH, offers her perspective on what the future holds for healthcare professionals and patients in response to the Supreme Court decision in Dobbs v. Jackson Women's Health Organization, to let states determine access to reproductive healthcare.

Nov 17, 2022
Telemedicine and Patient Care Access: Challenges in the Post-Roe Landscape
Telemedicine offers the potential both to bridge geographic gaps and to increase access to in-clinic appointments for pregnant patients. However, varying state laws and patient disparities continue to provide challenges for physicians.

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 12, 2022
Suicide and Crisis Lifeline: Call or Text 988
The National Suicide Prevention Lifeline is now 988, an easy-to-remember number for 24/7 crisis care.

Sep 19, 2022
Mitigating the Legal Risks of Urinary Tract Injury Following Gynecologic Surgery
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company
A recent review of gynecologic surgery claims involving urinary tract fistulas reveals the importance of expanding the scope of the informed consent conversation prior to surgery.
From The Doctor’s Advocate

Aug 26, 2022
Dispensing Sample Medications: Risk Management Strategies
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
If not carefully managed, sample medications can create issues that place patients and the practice at risk.

Jul 21, 2022
Effective Obstetrical Team Communication
Pamela Willis, JD, RN, Senior Patient Safety Risk Manager, The Doctors Company
Effective communication requires a team effort for the exchange of concise and relevant information.

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

May 31, 2022
The Role of the Medical Assistant in Your Office Practice
Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
A medical assistant (MA) can be a valuable addition to an office practice, but MAs should not perform tasks outside their scope of practice.

Apr 01, 2022
Delay in Diagnosing Breast Cancer: A Case Summary and Tips to Reduce Risk
Lisa M. McCorkle, MSN, MBA, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management, The Doctors Company
A delay in diagnosing breast cancer may result when a patient doesn’t follow through with diagnostic recommendations.

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.

Professional Education
Cervical Cancer Claims: A Review in Gynecology
Cervical 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

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.

Sep 23, 2021
The Malpractice Experience of Obstetricians with Shoulder Dystocia: Preparation May Mitigate Risks With This Unpredictable Event
Jacqueline Ross, RN, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company, Part of TDC Group; Larry Veltman, MD, FACOG, DFASHRM, Director, National Perinatal Information Center; and Peter S. Bernstein, MD, MPH, Professor and Program Director, Department of Obstetrics and Gynecology and Women’s Health, Maternal Fetal Medicine, Albert Einstein College of Medicine
Shoulder dystocia (SD) is a rare complication of vaginal delivery. The purpose of this study was to better understand factors that may contribute to medical malpractice claims with SD and to offer recommendations to practicing obstetricians regarding the management of SD.

Jul 16, 2021
Obstetrics and Gynecology: Frequently Asked Patient Safety Questions
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company
Our experts answer questions about topics in obstetrics and gynecology, including cesarean delivery on maternal request and screening mammograms.

Jun 11, 2021
Conflicting Guidelines on Screening Mammography Can Pose Risks
David B. Troxel, MD, Medical Consultant to The Doctors Company
Breast cancer screening guidelines issued by national organizations and medical specialties have inconsistent recommendations about mammogram screening ages and intervals, which can create potential liability for delayed or missed diagnoses. Learn how to reduce these mammography risks.

May 18, 2021
Patient Safety Tips for Obstetrics and Gynecology
Pamela Willis, BSN, JD, Senior Patient Safety Risk Manager, The Doctors Company
These strategies can help you keep your patients safe and reduce potential liability. The tips highlighted here include tracking test results, documenting prenatal records, discussing birth plans, and managing noncompliant patients.

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

Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II, The Doctors Company
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.

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.

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.

Dec 08, 2020
Suicide Prevention: Primary Care Is a Crucial Setting for Identifying Risk
Debra Davidson, MJ, CPPS, Senior Patient Safety Risk Manager, The Doctors Company
At any given time, some of your patients are having thoughts of suicide. Effective suicide prevention requires a comprehensive approach.

Professional Education
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
0.5 credit

Sep 02, 2020
Remote Patient Monitoring
Sue Boisvert, BSN, MHSA, Patient Safety Risk Manager II
The adoption of telehealth strategies has soared, including the use of remote devices that collect data and send it to the patient’s doctor in real time. Although remote monitoring has advantages for both providers and patients, it entails cyber liability risks.

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager
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.

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
2.3 credits

Jul 07, 2020
Weekend Call Presents Unique Challenges with Surrogate Birth
Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager, Department of Patient Safety and Risk Management.
Communication among healthcare providers, patients, and adoptive parents is critical.

Apr 16, 2020
Shoulder Dystocia Documentation: Implementing a Protocol
Pamela Willis, BSN, JD, Patient Safety Risk Manager II
Shoulder dystocia claims have traditionally been among the most problematic to defend.

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.

Jul 10, 2019
Delay in Treatment of Fetal Distress
Larry Veltman, MD, FACOG, CPHRM, DFASHRM, and Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety and Risk Management
We studied claims alleging delay in treatment of fetal distress in the hope of reducing neonatal injuries.

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.

Jan 15, 2019
Maternal Injury and Death Closed Claims Study
By Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety
Each year, 700 women die from complications related to childbirth in the U.S. This analysis of closed malpractice claims involving maternal injury and death identifies potential sources of patient injury and provides tools for enhancing safety in ob/gyn.

Video Jan 15, 2019
Preeclampsia/Eclampsia: Reduce the Risk of Maternal Death
Studying malpractice claims involving preeclampsia and eclampsia reveals the key factors leading to patient injury and steps that physicians and providers should take to reduce the risks of maternal injury or death. These results are shared by Darrell Ranum, JD, CPHRM, vice president of patient safety at The Doctors Company.

Video Jan 15, 2019
Preventing Maternal Deaths in the U.S.
Susan Mann, MD, discusses the three most common potentially preventable causes of maternal death identified by the CDC and the top factors that lead to patient injuries. She also provides tips for plans and precautions that all hospitals should put in place to prevent maternal death from postpartum hemorrhage, venous thromboembolism, and severe hypertension.

Video Jan 15, 2019
Postpartum Hemorrhage: Reduce the Risk of Maternal Death
Postpartum hemorrhage is the leading cause of maternal injury in medical malpractice claims. Darrell Ranum, JD, CPHRM, vice president of patient safety at The Doctors Company, explains how this condition results in injury or death and provides tips on how physicians and providers can reduce risks.

Nov 16, 2018
Opioid Addiction in Pregnant Women and Moms: How to Make a Difference
Hannah Snyder, MD, and Christine Pecci, MD
Treating pregnant women and mothers with opioid addiction calls for a well-informed approach to patient safety.

Video Aug 05, 2018
What to Expect from Litigation: Dr. Nye's Perspective
Dr. Elizabeth R. Nye, an obstetrician and gynecologist in Chicago, describes how she defended herself against a medical malpractice lawsuit involving a complicated delivery that led to the death of the infant. Dr. Nye recounts the emotional impact of the lawsuit.

Video May 23, 2018
Hospital Obstetrics: Innovations in Patient Safety
Marcus Tower, MD, an obstetrician at the Cleveland Clinic’s Hillcrest Hospital in Cleveland, Ohio, describes important data and recommendations for patient safety revealed in The Doctors Company’s Obstetrics Closed Claims Study. The study helped the hospital adopt changes that address common pitfalls obstetrics professionals may face, including abnormal fetal heart rate tracings, postpartum and massive hemorrhage, and shoulder dystocia.

Video May 18, 2018
Obstetrics: Innovations in Patient Safety
Jay M. Berman, MD, FACOG, of the Wayne State University Physician Group in Detroit, Michigan, describes changes his practice made to improve patient safety based on the data and recommendations in The Doctors Company’s Obstetrics Closed Claims Study. The study provided a common understanding on which colleagues, hospital administrators, residents, and nursing staff were able to work collaboratively to make changes to reduce the risk of shoulder dystocia and obstetric hemorrhage.

Mar 26, 2018
Nurse Practitioner Closed Claims: Risk Mitigation Strategies
Strategies to help nurse practitioners and physicians prevent patient injuries.
From The Doctor’s Advocate

Video Feb 10, 2018
What to Expect from Litigation: Dr. Michelin's Perspective
Dr. David P. Michelin, a gynecologic oncologist in Traverse City, Michigan, relates his experience with a malpractice suit involving a hysterectomy and staging for uterine cancer.

Aug 28, 2017
Obstetrical Closed Claims: What Can We Learn?
Robin Diamond, JD, RN, Senior Vice President, Department of Patient Safety and Risk Management, and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
These lessons learned from our analysis of closed obstetrical claims are part of our CME article series.
From The Doctor’s Advocate

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Reproductive Healthcare: Post-Roe Resource Center

Get the latest information on responding to the new ambiguity of reproductive medicine in the post-Roe landscape.

LEARN MORE