Abstract
The analysis of closed claims and litigations can provide an invaluable tool to improve patient safety by minimizing adverse anesthesia-related outcomes. Analysis of collective data describing such claims is integral to develop new guidelines aimed to reduce adverse anesthesia-related events. In this study, we give a descriptive analysis of anesthesia-related claims at the Detroit Medical Center, Detroit, MI, USA. The study analyzed different components in anesthesia-related closed claims and litigations such as medical, demographic and socio-economic factors. From 67,000 procedures in anesthesiology care provider, related cases claims were made in 0.057% (38/67,000) of all cases. The majority of claims involved procedures involving Caucasian females aged 51-55 years. The highest risk periods involved early shift times during Monday and Tuesday, particularly of procedures performed during August. About 33% of all cases in which death occurred involved patients who received an Obstetrics/Gynecology or an Orthopedic procedure under general anesthesia. The majority of closed claims and litigations cases were distributed between procedures treating nerves injuries and anoxic encephalopathy. The OR and PACU at urban hospitals had the highest claim rates. MD anesthesiologists constituted the lowest proportion of all anesthesia providers involved in closed claims incidents. The average compensation paid was predominately in the range of $200,000-$250,000. In addition to reporting anesthesia related factors involved in closed claims and litigations this study also includes a series of recommendations which may work as a framework for improving anesthesia practices.
Highlights
The use of regional and general anesthesia and analgesia can result in various adverse complications
The American Society of Anesthesiologists Closed Claims Project (ASA-CCP) reveals data obtained from the American medical liability insurance companies regarding outcomes of anesthesia-related closed claims [7]
Anesthesiology remains at the upper tier in terms of the cost medical malpractice claims [8]
Summary
The use of regional and general anesthesia and analgesia can result in various adverse complications. The term medical liability claim refers to a claim that an action in medical practice deviates from acceptable standards, presumably resulting in the death or injury of a patient, entitling legal responsibly before the law [1]. These incidents are usually tracked and evaluated in many countries using set standards [3]-[6]. One or more anesthesiologists are named as defendants in anesthesia related litigations at the Detroit Medical Center (DMC) These litigations may end up dismissed, settled, or trialed. Often, such litigations result in financial restitution to the patient and often can lead to changes in policies and improvement of medical procedures at our institution
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