Obstetrics and Gynecology

Professional Education
Ob/Gyn: Telephone Communications (Claims Corner CME)
The most frequent inconsistent practice found in the Practice Risk INSIGHT assessments was telephone communication (22 percent not met). When appropriate and adequate systems are in place, the physician is less at risk for having a suit filed. This case-based study provides insights and risk management techniques to lessen the frequency and severity of such a claim.
0.5 credits

Video Apr 09, 2019
Study of Malpractice Claims Involving Children
Patient safety risks when treating children vary depending on the patient’s age—but communication breakdowns between doctors and patients/families occur in malpractice claims for pediatric patients of ALL ages. Watch this important case study to learn more.

Mar 20, 2019
Preview Our Study of Malpractice Claims Involving Children
Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety and Risk Management
Highlights from our analysis of 1,215 pediatric patient claims filed over a 10-year period.
From The Doctor’s Advocate

Mar 20, 2019
Study of Malpractice Claims Involving Children
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.

Feb 15, 2019
Is Your Patient a Victim of Human Trafficking?
Amy Wasdin, RN, MBA, Patient Safety Risk Manager II
A visit to a physician or dental practice may provide an opportunity to help a human trafficking victim.

Jan 15, 2019
Maternal Injury and Death Closed Claims Study
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
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.

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
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.

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.

Oct 26, 2018
Patient Safety Tips for Obstetrics and Gynecology
Pamela Willis, BSN, JD, Patient Safety Risk Manager II
In obstetrics and gynecology, doctors can reduce potential liability by following risk management strategies, such as adopting an "induction checklist."

Video Sep 27, 2018
Future of Healthcare: Physicians Won't Recommend Their Profession
The Future of Healthcare Survey of over 3,400 doctors shows physicians are disenchanted with practicing medicine, largely because of technologies and payment models they say are interfering with the doctor-patient relationship and their ability to provide quality care. Despite continuing volatility in the industry and resulting dissatisfaction, one of the predominant themes captured in this survey is the concern physicians share for their patients and the quality of the care they receive.

Jul 27, 2018
Distracting Devices in Healthcare: Malpractice Implications
Digital distraction in healthcare is emerging as a great 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
The Risks of Distracted Practice in the Perioperative Area
The invasion of personal electronic devices (PEDs) into certain healthcare environments can put patients at risk. The perioperative area is an environment where distraction from PEDs can lead to patient injury or death. This activity provides tools and information for individuals to become aware of risks, to assess how PEDs impact their environment, and to develop preventive measures to control PED usage.
1.5 Credits

Jun 26, 2018
Conflicting Guidelines on Mammograms Can Pose Risks
David B. Troxel, MD, Medical Director, 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.

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.

Apr 25, 2018
A Complication Involving Laparoscopic Lysis of Adhesions
David B. Troxel, MD, Medical Director, Board of Governors
A medical malpractice case about laparoscopic lysis of adhesions involved negligent performance of surgery and mismanagement of postoperative care.

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

Professional Education
Preventing Adverse Outcomes: Obstetrics
This activity is based on The Doctors Company's guide to reducing patient safety risks in obstetrics and gynecology. It is intended to provide essential training for obstetricians, gynecologists, family practitioners, and advanced practice providers who are actively involved in delivering women’s healthcare. 
3.0 Credits

Professional Education
Spotlight On Preventing Obstetrical Claims [The Doctor's Advocate CME]
This activity highlights The Doctors Company's insights into preventing obstetrical claims by sharing the most likely risks encountered by obstetricians and preventive actions that have proven effective at mitigating these risks.
1.25 Credits

Oct 24, 2017
Give Your Patient Safety Culture a Check Up Using Assessment Survey
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Healthcare managers are making concerted efforts to cultivate a pervasive culture of patient safety. Creating a patient safety culture shifts the focus away from the blame game that punishes individuals for failures—which can increase liability over the long term—toward creating policies and procedures that cultivate an environment of openness and foster patient safety.

Oct 24, 2017
Doctors Examine Injury Risks with Malpractice Closed Claims
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Taking a close look at research into real-life malpractice claims and incorporating some of the findings into their practices is one way physicians are reducing risks of adverse events.

Professional Education
Diagnosing Breast and Cervical Cancers
This activity, designed for providers who are actively involved in delivering women’s healthcare, presents lessons gleaned from The Doctors Company malpractice claims related to diagnosing breast and cervical cancers. It includes data analysis by experts and discussion of established best practices.
1.5 Credits

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

May 03, 2017
Guide to Patient Safety and Reducing Liability in Obstetrics and Gynecology
This topic-based guide to reducing liability in obstetrics and gynecology is an essential reference for obstetricians, gynecologists, family practitioners, and advanced practice providers who are actively involved in delivering women’s healthcare.

Apr 10, 2017
Latex Precautions in Obstetrics and Gynecology
Rosanne Cain, BSN, LHRM, Patient Safety/Risk Manager II
Recognizing latex allergies is an important patient safety precaution.

Mar 31, 2017
Case Summary: A Delay in Diagnosing Breast Cancer
Donald Wood CRNA, CPHRM, Patient Safety Risk Manager II, Department of Patient Safety and Risk Management
There are numerous reasons patients might be non-adherent with diagnostic testing recommendations. Many people fear a cancer diagnosis, especially breast cancer.

Mar 01, 2017
Reduce Patient Safety Risks with Vaccinations
Debbie Hill, RN, MBA, CPHRM, and Lisa McCorkle, MSN, CPHRM, Patient Safety Risk Managers, The Doctors Company
Whether seeing patients for back-to-school immunizations or preparing adult patients for travel abroad, this article can help doctors assess the vaccine administration protocol in their practice to reduce risks and enhance patient safety.

Mar 01, 2017
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.

Feb 18, 2017
Up for Review: Five Keys to Managing Online Criticism
Kevin Pho, MD, Founder and Editor, KevinMD.com
No matter how professional and caring a doctor you may be, eventually you will face criticism on the web. Here are five keys to managing that criticism.

Nov 30, 2016
Watch for the Signs: Screen All Patients for Suicidal Thoughts
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Patients with suicidal thoughts or ideation appear occasionally in physician encounters. Any patient, no matter what issue is being treated and in any setting, could be at risk for suicide. A consistent and formal screening process, plus a response plan, will protect both the patient and the physician.

May 12, 2016
Obesity: A Common Comorbidity in Malpractice Claims
David B. Troxel, MD, Medical Director, Board of Governors
From The Doctor’s Advocate

May 12, 2016
Specialty Advisory Boards: Bringing Together Expertise
Robin Diamond, JD, RN, Senior Vice President, Department of Patient Safety and Risk Management, and Miranda Felde, MHA, CPHRM, Assistant Vice President, Department of Patient Safety and Risk Management
We provide forums for healthcare leaders to exchange ideas and identify ways to help us advance the practice of good medicine.
From The Doctor’s Advocate

May 01, 2016
Effective Obstetrical Team Communication
Cynthia Morrison, RN, CPHRM, Senior Patient Safety/Risk Manager
Effective communication requires a team effort for the exchange of concise and relevant information.

Dec 08, 2015
New Early Warning Criteria Could Reduce Maternal Mortality
Susan Mann, MD, The Doctors Company OB Advisory Board Member
Guest author Dr. Susan Mann reports on a new initiative to address the significant increase in maternal deaths.
From The Doctor’s Advocate

Oct 19, 2015
Navigating Risks in Breast Cancer Diagnosis and Treatment: How Physicians Can Enhance Patient Safety
Penny Greenberg, RN, MS, Senior Program Director, Patient Safety Services, CRICO Strategies; Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management, The Doctors Company; Dana Siegal, RN, CPHRM, Director, Patient Safety, CRICO Strategies
Patients diagnosed with breast cancer must navigate the complex healthcare system while dealing with the emotions of their diagnosis, relying on the expertise, communication, and empathy of caregivers who practice in environments with inherent risks. A study by The Doctors Company and CRICO Strategies reveals the top patient safety risks in breast cancer diagnosis and treatment, and how to reduce those risks.

Video Aug 05, 2015
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.

Jul 13, 2015
Shoulder Dystocia Documentation: Implementing a Protocol in Your Facility
Pamela Willis BSN, JD, Patient Safety Risk Manager.
Shoulder dystocia claims have traditionally been among the most problematic to defend.

Video May 05, 2015
Obstetrics: Top Patient Safety Risks
A study of 882 closed obstetrics malpractice claims revealed the most common patient allegations and the most common factors that contribute to patient injury.

May 01, 2015
Tips for Reducing Medical Malpractice Claims in Obstetrics
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. These tips can help physicians address these risks.

May 01, 2015
Obstetrics Closed Claims Study
This review of 882 obstetrical claims identifies the most common patient allegations and the specific factors contributing to patient injury.

Video Feb 10, 2015
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.

Dec 10, 2014
Editorial Comment on Maintenance of Certification
David B. Troxel, MD, Medical Director, Board of Governors
Dr. Troxel suggests ways to restructure the MoC examination process to adapt it to changes in the healthcare delivery system.
From The Doctor’s Advocate

Dec 02, 2014
Diagnostic Error in Medical Practice by Specialty
David B. Troxel, MD, Medical Director, Board of Governors
This closed claim review focuses on the variance between specialties in the incidence of diagnosis-related error.
From The Doctor’s Advocate

Aug 23, 2014
Patient Safety Alert: ACOG Releases Special Report
From The Doctor’s Advocate

Video Jul 08, 2014
How to Create a Patient-Centered Team Structure
In the past, labor and delivery units were structured for the convenience of the staff. But adjusting the structure to better reflect patient needs can be a boon for both physicians and patients.

Dec 20, 2013
Interactive Guide to Patient Safety for Office Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your practice.

Sep 20, 2013
Avoid Missed or Delayed Diagnosis of BRCA-Based Breast Cancer
Physicians should be aware of the risk factors for BRCA gene-based cancer in order to identify those who need testing and to avoid delayed or missed diagnosis.

Feb 01, 2013
Interactive Guide for Obstetrical Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your obstetrical practice.

Dec 14, 2012
Interactive Guide for Hospitals: Clinical Departments: Obstetrics (OB) Units
This guide can help uncover areas of potential malpractice exposure in the obstetrics (OB) unit.

Aug 27, 2012
Preventing Delayed Treatment of Fetal Distress
Excerpted by Patti Herrera, RN, BSN, Patient Safety Analyst, from “Delay in Treatment of Fetal Distress” an article by Larry Veltman, MD, and Darrell Ranum, JD, CPHRM, that originally appeared in The Doctor’s Advocate, third quarter 2012 (www.thedoctors.com/advocate).
Preventing delay in treatment of fetal distress requires readiness for and recognition and management of complications, improved communications, and required technical skills.

Aug 23, 2012
Delay in Treatment of Fetal Distress
Larry Veltman, MD, and Darrell Ranum, JD, CPHRM
We studied claims alleging delay in treatment of fetal distress in the hope of reducing neonatal injuries.

Aug 01, 2012
Frequently Asked Questions: Obstetrics and Gynecology
Cynthia Morrison, RN, CPHRM, Patient Safety/Risk Management Account Executive.
Our experts answer questions about topics in obstetrics and gynecology, including cesarean delivery on maternal request and screening mammograms.

Mar 01, 2008
Getting Sued for Breast Cancer
This article, originally published in The Doctor’s Advocate in 2001, was written by Chairman and CEO Richard E. Anderson, MD, FACP.
Suits involving breast cancer are the most common cause of malpractice litigation in the United States. This article lists the most common issues that lead to claims.