Obstetric ultrasound − its risks and the cost of addressing them

Graham Robert Howarth,Stephanie Bown

doi:10.4102/sajr.v17i3.274

Abstract

Until recently, obstetric claims (which are invariably high-value) used to be clustered around problems related to labour. However, a second group of high-value claims is emerging: those related to missed abnormaltities. The value of claims is now so high that a single individual is unable to compensate a claimant adequately, and indemnity is therefore essential. Although such claims are relatively rare, indemnity costs are high as the claims are large. The high value of obstetric claims, including those for missed abnormalities, is reflected in the cost of indemnity for obstetricians and those performing antenatal ultrasound.

Highlights

Children born following obstetric misadventure are usually severely compromised and require specialised care and sophisticated treatment that allows them to live longer and more fulfilling lives
Indemnity costs for obstetricians are far higher than most other specialties; with few exceptions, obstetricians’ indemnity costs are multiples of those of other specialities, and may threaten private obstetric care in South Africa by the end of the decade.[1,2]
Most high-value obstetric claims concerned intrapartum problems – mainly cerebral palsy related to mismanaged intrapartum care

Summary

Introduction

Children born following obstetric misadventure are usually severely compromised and require specialised care and sophisticated treatment that allows them to live longer and more fulfilling lives. All that was needed to perform ultrasound in pregnancy was appropriate equipment, an operator and a willing pregnant patient.[8] Each time an obstetric ultrasound is performed, there is a risk that an abnormality may be missed. While an individual’s risk of having a claim made may be relatively low, the magnitude of a missed abnormality claim’s value is so high that a single individual could not afford to compensate a deserving claimant.[1,9] What can individuals do to negate that risk?

Results

Conclusion