Abstract
We aim to analyze the characteristics of radiation oncology (RO) malpractice cases and identify opportunities to decrease patient harm. The Controlled Risk Insurance Company (CRICO) Strategies’ Comparative Benchmarking System (CBS) is a repository of approximately 30 percent of the closed US malpractice cases and contains 99 RO cases from 2005-2014, 95 of which are closed. Data on 41 ambulatory RO cases from 1/1/2009-12/31/2013 were available for immediate analysis. We identified the average incurred loss by major allegation and by sponsoring institutions by Academic Medical Center [AMC] versus Community Hospitals. Forty-one ambulatory RO cases (with $7 million total incurred loss) had data on the major allegations; 80% of cases had medical treatment allegations. Medical treatment allegations had an average total incurred (ATI) of $199,324 and were most commonly classified as: improper performance of treatment or procedure (66% of all cases with $210,127 ATI) and wrong or unnecessary treatment or procedure (7% of all cases with $281,179 ATI) [Table]. Overall, medical treatment allegation payments were higher in community hospitals ($206,266) compared with AMC ($99,331). Allowing for multiple causative factors, technical skill was the major contributor in community hospital RO cases, followed by communication and clinical judgment (present in 36%, 31%, and 25% of cases, respectively). Most ambulatory RO cases involved improper performance of treatment/procedure or wrong/unnecessary treatment/procedure with technical skill as the most likely contributing factor in both AMC and community hospitals cases. These results support the need for continuing initiatives to improve safety and decease litigation in radiation oncology.Abstract 3333; TableMedical Treatment Allegations in Ambulatory RO Cases%Average Total IncurredImproper performance of treatment or procedure83%$210,127Wrong or unnecessary treatment or procedure9%$281,179Improper management of treatment course6%$11,367Premature end of treatment or abandonment3%$37,999 Open table in a new tab
Published Version
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