National Practitioner Data Bank Research Articles

Medical malpractice litigation and daylight saving time.

Daylight saving time (DST) constitutes a natural quasi-experiment to examine the influence of mild sleep loss and circadian misalignment. We investigated the acute effects of spring transition into DST and the chronic effects of DST (compared to standard time) on medical malpractice claims in the United States over three decades. We analyzed 288,432 malpractice claims from the National Practitioner Data Bank. To investigate the acute effects of spring DST transition, we compared medical malpractice incidents/decisions one week before spring DST transition, one week following spring DST transition, and the rest of the year. To investigate the chronic effects of DST months, we compared medical malpractice incidents/decisions averaged across the 7-8 months of DST versus the 4-5 months of standard time. With regard to acute effects, spring DST transitions were significantly associated with higher payment decisions, but not associated with the severity of medical incidents. With regard to chronic effects, the 7-8 DST months were associated with higher average payments and worse severity of incidents than the 4-5 standard time months. The mild sleep loss and circadian misalignment associated with DST may influence incidence of medical errors and decisions on medical malpractice payments both acutely and chronically.

Association between the American Board of Emergency Medicine Oral Certifying Examination and Future State Medical Board Disciplinary Actions.

The American Board of Emergency Medicine (ABEM) requires a written examination (the Qualifying Examination) followed by the Oral Certifying Examination (OCE) to obtain ABEM certification. Maintaining ABEM certification is associated with fewer state medical board (SMB) disciplinary actions. We sought to determine the association between poor initial performance on the OCE and subsequent severe SMB disciplinary action. We included physicians who completed US categorical emergency medicine residencies in 2016 and earlier. We classified OCE performance as good (passed on first attempt) and poor (never passed or required>1 attempt to pass). We obtained data on physician SMB disciplinary actions from the National Practitioner Data Bank that were limited to actions that denied licensure or altered the status of a medical license (eg, suspension). We determined the association between poor OCE performance and subsequent severe SMB disciplinary action. Of 34,871, 93.5% passed the OCE on the first attempt, 6.1% required multiple attempts, and 0.3% never passed. Of the physicians (93.5%) with good OCE performance, 1.0% received a severe SMB action. Among physicians with poor OCE performance, 2.3% received a severe action; and of those who never passed, 1.7% received a severe action (Table 1). Poor OCE performance was associated with an increased odds of severe SMB disciplinary action (OR 2.21, 95% CI: 1.57-3.12). Physicians with poor OCE performance exhibited higher odds of experiencing a subsequent severe SMB disciplinary action. The OCE may have utility as a predictor of future professionalism or clinical performance.

Medical Malpractice Payment Reports of Physician Assistants/Associates Related to State Practice Laws and Regulations

ABSTRACT Purpose: Authorizing physician assistants/associates (PAs) to provide care to patients and removing restrictive laws and regulations without sacrificing patient safety is essential to meet the needs of patients and the US healthcare system. The aim of this observational study was to determine if states with permissive compared to restrictive PA scope of practice laws and regulations had higher instances of medical malpractice payment reports (MMPR), a proxy of patient harm. Design: This observational study examined 10 years (2010-2019) of medical malpractice payment reports data from the National Practitioner Data Bank (NPDB) compared to the laws and regulations of states for the same period. Results: Negative binomial regressions indicated no statistically significant differences in MMPR rates between states with permissive versus restrictive PA practice laws and regulations. Five of six practice reforms decreased or had no significant effect on PA and physician MMPR occurrences. One reform was associated with a weak but statistically significant increased risk of MMPRs for PAs and a trend toward a decreased risk for physicians. Conclusion: This study suggests that removing restrictive laws and regulations to PA practice does not increase overall risks to patients or increase rates of malpractice within US healthcare.

Extending COVID-19 Pharmacy Technician Duties: Impact on Safety and Pharmacist Jobs.

Background: The 2019 coronavirus pandemic (COVID-19) led to an expanded scope of practice for pharmacy technicians. As the pandemic wanes, state governments are faced with the decision of whether or not to make permanent the authority of pharmacy technicians to perform extended duties. Objective: Determine the impacts on patient safety and job market demands preadoption and postadoption of Idaho's expanded technician duties in 2017 as a natural experiment for expanded technician duties. Methods: Data from the National Practitioner Data Bank (NPDB) is used to explore patient safety outcomes in Idaho preadoption and postadoption and as compared with its border states. Data from Pharmacy Demand Reports is used to compare job postings in Idaho and its border state, and National Association of Boards of Pharmacy census data are used to compare growth in the number of pharmacists and technicians in Idaho and its border states over time. Results: For Idaho pharmacists, the average number of disciplinary actions reported against both pharmacists and technicians dropped after implementation of expanded technician duties. Idaho also had a lower rate of discipline for pharmacists and technicians than its border states. Idaho had the third highest job postings for pharmacists and the second highest for technicians among its border states. Idaho also had the largest growth in the number of licensed pharmacists and technicians of the observed states in the study period. Conclusion: Available statewide data from Idaho as compared with its border states suggests that expanded technician duties did not adversely impact patient safety outcomes or the pharmacist job market. Additional states may wish to expand pharmacy technician duties in the years ahead.

Constitutional Violations by the Health Care Quality Improvement Act (HCQIA) and the Reporting by the National Practitioner Databank (NPDB): Focusing on the Preservation of the Civil Rights of Physicians

In 1986, the US Congress passed the Health Care Quality Improvement Act of 1986. (HCQIA) was designed to protect the health and safety of the public by 1) enhancing the Peer Review process through protection for peer review members from lawsuits, and 2) providing a national repository for reported information regarding medical malpractice payments and adverse actions involving physicians, which among other things, would monitor the movement of incompetent or unprofessional physicians. The framers of HCQIA did not foresee that in 2023, hospitals and employers will invariably deny employment and/or hospital privileges based on an NPDB report outlining loss of hospital privileges or relinquishment of hospital privileges under investigation. Such an adverse report by NPDB results in the inability of the physician to obtain employment or practice in a hospital. Therefore, in 2023, the unintended consequence of the reporting of adverse peer review actions by NPDB, an agency of the Federal Government, can violate the constitutional and civil rights of the said physicians.

Constitutional Violations by the Health Care Quality Improvement Act (HCQIA) and the Reporting by the National Practitioner Databank (NPDB): Focusing on the Preservation of the Civil Rights of Physicians

In 1986, the US Congress passed the Health Care Quality Improvement Act of 1986. (HCQIA) was designed to protect the health and safety of the public by 1) enhancing the Peer Review process through protection for peer review members from lawsuits, and 2) providing a national repository for reported information regarding medical malpractice payments and adverse actions involving physicians, which among other things, would monitor the movement of incompetent or unprofessional physicians. The framers of HCQIA did not foresee that in 2023, hospitals and employers will invariably deny employment and/or hospital privileges based on an NPDB report outlining loss of hospital privileges or relinquishment of hospital privileges under investigation. Such an adverse report by NPDB results in the inability of the physician to obtain employment or practice in a hospital. Therefore, in 2023, the unintended consequence of the reporting of adverse peer review actions by NPDB, an agency of the Federal Government, can violate the constitutional and civil rights of the said physicians. The NPDB reporting provision of HCQIA violates 5th, 8th, 9th and 10th amendments of the Constitution.

Trends in Malpractice Payments and Adverse Actions against Pharmacists in the United States between 1990-2022

Background: We evaluated malpractice payments and adverse actions against pharmacists in the United States. Malpractice is defined as professional negligence by act or omission. Adverse actions are actions administered by the board of registration in a health profession against a provider. The purpose of the study is to analyze the trends in malpractice payments and adverse actions for pharmacists during the period 1990-2022. Methods: This is a retrospective study that utilizes the National Practitioner Data Bank (NPDB) data analysis tool for the period 1990-2022. This information was exported to a data visualization tool and trends were studied. Results: During the period of the study there were 2480 malpractice payments and 44,204 adverse action reports made against pharmacists. In the current study we found that there has been a 19.56% decline in the number of malpractice payments against pharmacists in the last 5 years from 46 in 2018 to 37 in 2022. Similarly, adverse action reports also show a downward trend from 2016 to 2022. Conclusion: Pharmacy profession implements multiple processes to protect patients from medication errors. As the volume of prescriptions increases in the US, there is an increased risk of error and subsequent litigation against pharmacists. Even though malpractice payments and adverse actions against pharmacists have continued to decline, the probability of an adverse action remains high for practicing pharmacists. As the role of pharmacist continues to evolve there is a need to keep up with the changes in the healthcare market.

Dismantling Structures That Impede Clinical Social Work Practice

The current study examined the relationship between pre-licensure supervised experience requirements and license violations in order to ascertain whether jurisdictions requiring higher numbers of hours of supervised experience to obtain clinical social worker (CSW) licensure had fewer violations. The purpose of the study was to explore if there is a measure of “enough” supervised experience without compromising protection of the public. Three data files were used to complete the study: National Practitioner Data Bank (NPDB), Association of Social Work Boards (ASWB)’s Supervision Requirements per Jurisdiction Data, and ASWB’s U.S. Social Work Licensee Data. Results indicated that jurisdictions requiring less than 4,000 hours of supervised experience reported fewer violations than would be expected, whereas jurisdictions requiring 4,000+ hours of supervised experience reported more violations than would be expected given the number of CSWs within the respective groups. Results question the practice of requiring higher amounts of supervised experience as a regulatory standard. Implications for social work regulation include support for nationally standardizing the required amounts of supervised experience outlined by Groshong (2011) and the ASWB (2018) Model Social Work Practice Act.

Impact of “Defensive Medicine” on the Costs of Diabetes and Associated Conditions

Geographic variation in health care spending is typically attributed to differences in patient health status and provider practice patterns. While medicolegal considerations (i.e., "defensive medicine") anecdotally impact health care spending, this phenomenon is difficult to measure. The purpose of this study was to explore the association between the medicolegal environment and Medicare costs for diabetes and associated conditions of interest to vascular surgeons. Specifically, we hypothesized that an adverse medicolegal environment is associated with higher per capita Medicare costs for diabetic patients. Medicare data including the most recent (2018) Medicare Geographic Variation Public Use Files and Chronic Conditions Data Files were linked to National Practitioner Data Bank files from the preceding 5years (2013-2017), in addition to the US census data and American Medical Association workforce statistics. The state-level medicolegal environment was characterized by K-means clustering across a panel of metrics related to malpractice payment magnitude and prevalence. Per capita Medicare spending for diabetes was compared across 5 distinct medicolegal environments. Costs were standardized and risk-adjusted to account for known geographic variation in health care costs and patient population. Analysis of variance was applied to unadjusted data, followed by multivariate regression modeling. Readmission rates, per capita imaging studies, per capita tests, per capita procedures, and lower extremity amputation rates were compared between the least litigious quintile from the K-means clustering and the 2 most litigious quintiles. The median unadjusted Medicare per capita expenditure on diabetic patients was $15,963 ($14,885-$17,673), ranging from $13,762 (Iowa) to $21,865 (D.C.). A 1.6-fold variation persisted after payment standardization. Cluster analysis based on malpractice-related variables yields 5 distinct medicolegal environments, based on litigation frequency and malpractice payment amounts. Per capita spending on diabetes varied, ranging from $15,799 in states with low payments and infrequent litigation to $18,838 in states with the most adverse medicolegal environment (P<0.05). After cost standardization and risk adjustment with multiple linear regression, malpractice claim prevalence (per 100 physicians) remained an independent predictor of states with the highest diabetes mellitus spending (P=0.022). Moreover, diabetic patients in states with adverse medicolegal environments had more procedures, imaging studies, and readmissions (P<0.05 for all) but did not have significant differences in amputation rates compared to less litigious states. An adverse medicolegal environment is independently associated with higher health care costs but does not result in improved outcome (i.e. amputation rate) for diabetic Medicare beneficiaries. Across states, a 1% increase in lawsuits/100 physicians was associated with a >10% increase in risk-adjusted standardized per capita costs. These findings demonstrate the potential contribution of "defensive medicine" to variation in health care utilization and spending in a population of interest to vascular surgeons.

What Federal Practitioners Need to Know About the National Practitioner Data Bank.

The National Practitioner Data Bank (NPDB) is a federal online repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers. Not only can health care entities, including federal health care programs, request information from the NPDB about federal practitioners, these entities in certain circumstances can submit reports concerning their adverse actions and malpractice payments to the NPDB. Federal practitioners can appeal these reports through a formal process with the NPDB. The NPDB regulations specifically affecting federal practitioners may be different from those of health care practitioners in the private sector.

Cross-State Licensure Laws for Telehealth Evolve During Pandemic

Cross-State Licensure Laws for Telehealth Evolve During Pandemic

Protecting the Public’s Health-Except in Tennessee

No abstract available. Article truncated after 150 words. State regulatory boards that regulate professionals such as doctors, nurses, psychologists, etc. are often appointed by politicians and headed by lawyers. Under this category has been most Medical Boards and their parent organization the Federation of State Medical Boards. Although they claim to be protecting the public, they seem more concerned with identifying “disruptive” physicians and blacklisting them through the National Practitioner Data Bank (1). However, in July the Federation issued a warning to physicians against propagating COVID-19 vaccine misinformation and disinformation citing a "dramatic increase" by physicians (2). The statement gave some hope that the Federation was striving to maintain some degree of professional standards by saying that spreading disinformation to the public was dangerous because physicians enjoy a high degree of public credibility. The Tennessee Board of Medical Examiners followed the Federation’s lead by issuing a verbatim restatement warning that physicians who spread false information about COVID-19 vaccinations …

Association Between US Physician Malpractice Claims Rates and Hospital Admission Rates Among Patients With Lower-Risk Syncope

The US Government Accountability Office has changed its estimate of the annual costs of defensive medicine, largely because it has been difficult to objectively measure its impact. Evaluating the association of malpractice claims rates with hospital admission rates and the costs of admitting patients with low-risk conditions would help to document the impact of defensive medicine. Although syncope is a concerning symptom, most patients with syncope have a low risk of adverse outcomes. However, many low-risk patients are still admitted to the hospital, with associated costs of more than $2.5 billion per year in the US. To assess whether hospital admission rates after emergency department visits among patients with lower-risk syncope are associated with state-level variations in malpractice claims rates. This cross-sectional study of emergency department visits among patients with lower-risk syncope used deidentified data from the Clinformatics Data Mart database (Optum). Lower-risk syncope visits were defined as those with a primary diagnosis of syncope and collapse based on International Classification of Diseases, Ninth Revision, Clinical Modification code 780.2 or International Classification of Diseases, Tenth Revision, Clinical Modification code R55 that did not include another major diagnostic code for a condition requiring hospital admission (such as heart disease, cancer, or medical shock) or an inpatient hospital stay of more than 3 days. These data were linked to publicly available data from the National Practitioner Data Bank pertaining to physician malpractice claims between January 1, 2008, and December 31, 2017. The 2 data sets were linked at the state-year level. Data were analyzed from October 2, 2019, to September 12, 2020. The association between the rate of hospital admission after emergency department visits among patients with lower-risk syncope and the rate of physician malpractice claims was assessed at the state-year level using a state-level fixed-effects model. Standardized costs obtained from the Clinformatics Data Mart database were adjusted for inflation and expressed in 2017 US dollars using the Consumer Price Index. Among 40 482 813 emergency department visits between 2008 and 2017, 519 724 visits (1.3%) were associated with syncope. Of those, 234 750 visits (45.2%) met the criteria for lower-risk syncope. The mean (SD) age of patients in the lower-risk cohort was 71.8 (13.5) years; 141 050 patients (60.1%) were female, and 44 115 patients (18.8%) were admitted to the hospital, representing an extra cost of $6542 per admission. The mean rate of physician malpractice claims varied from 0.27 claims per 100 000 people to 8.63 claims per 100 000 people across states and across years within states. A state-level fixed-effects regression model indicated that, for every 1 in 100 000-person increase in the physician malpractice claims rate, there was an absolute increase of 6.70% (95% CI, 4.65%-8.75%) or a relative increase of 35.6% in the hospital admission rate, which represented an additional $102 million in costs associated with this lower-risk cohort. In this study, increases in physician malpractice claims rates were associated with increases in hospital admission rates and substantial health care costs for patients with lower-risk syncope, and these increases are likely associated with the practice of defensive medicine.

Does state malpractice environment affect outcomes following spinal fusions? A robust statistical and machine learning analysis of 549,775 discharges following spinal fusion surgery in the United States.

Spine surgery is especially susceptible to malpractice claims. Critics of the US medical liability system argue that it drives up costs, whereas proponents argue it deters negligence. Here, the authors study the relationship between malpractice claim density and outcomes. The following methods were used: 1) the National Practitioner Data Bank was used to determine the number of malpractice claims per 100 physicians, by state, between 2005 and 2010; 2) the Nationwide Inpatient Sample was queried for spinal fusion patients; and 3) the Area Resource File was queried to determine the density of physicians, by state. States were categorized into 4 quartiles regarding the frequency of malpractice claims per 100 physicians. To evaluate the association between malpractice claims and death, discharge disposition, length of stay (LOS), and total costs, an inverse-probability-weighted regression-adjustment estimator was used. The authors controlled for patient and hospital characteristics. Covariates were used to train machine learning models to predict death, discharge disposition not to home, LOS, and total costs. Overall, 549,775 discharges following spinal fusions were identified, with 495,640 yielding state-level information about medical malpractice claim frequency per 100 physicians. Of these, 124,425 (25.1%), 132,613 (26.8%), 130,929 (26.4%), and 107,673 (21.7%) were from the lowest, second-lowest, second-highest, and highest quartile states, respectively, for malpractice claims per 100 physicians. Compared to the states with the fewest claims (lowest quartile), surgeries in states with the most claims (highest quartile) showed a statistically significantly higher odds of a nonhome discharge (OR 1.169, 95% CI 1.139-1.200), longer LOS (mean difference 0.304, 95% CI 0.256-0.352), and higher total charges (mean difference [log scale] 0.288, 95% CI 0.281-0.295) with no significant associations for mortality. For the machine learning models-which included medical malpractice claim density as a covariate-the areas under the curve for death and discharge disposition were 0.94 and 0.87, and the R2 values for LOS and total charge were 0.55 and 0.60, respectively. Spinal fusion procedures from states with a higher frequency of malpractice claims were associated with an increased odds of nonhome discharge, longer LOS, and higher total charges. This suggests that medicolegal climate may potentially alter practice patterns for a given spine surgeon and may have important implications for medical liability reform. Machine learning models that included medical malpractice claim density as a feature were satisfactory in prediction and may be helpful for patients, surgeons, hospitals, and payers.

Experiences of neurological surgeons with malpractice lawsuits.

As a specialty that treats acute pathology and refractory pain, neurosurgery is at risk for high liability, making the practice of defensive medicine quite common. The extent to which the practice of defensive medicine is linked to experience with malpractice lawsuits remains unclear. The aims of this study were to clarify this by surveying neurosurgeons about the frequency of experiencing medical lawsuits and to show how neurosurgeons reflect on facing such lawsuits. A survey consisting of 24 questions was distributed among members of the Congress of Neurological Surgeons. The survey consisted of four parts: 1) demographics of participants; 2) the way malpractice lawsuits affect the way respondents practice medicine; 3) experiences with medical malpractice lawsuits; and 4) the effect of the medical malpractice environment on one's own practice of medicine. There were a total of 490 survey respondents, 83.5% of whom were employed in the US. Of the respondents, 39.5% stated they were frequently or always concerned about being sued, and 77.4% stated their fear had led to a change in how they practice medicine. For 58.4%, this change led to the practice of defensive medicine, while for others it led to more extensive documentation (14.3%) and/or to referring or dropping complex cases (12.4%).Among the respondents, 80.9% at some time were named in a medical malpractice lawsuit and 12.3% more than 10 times. The main concerns expressed about being sued included losing confidence and practicing defensive medicine (17.8%), personal assets being at risk (16.9%), and being named in the National Practitioner Data Bank (15.6%). Given the medical malpractice environment, 58.7% of respondents considered referring complex patient cases, whereas 36.5% considered leaving the practice of medicine. The fear of being sued (OR 4.06, 95% CI 2.53-6.51) and the consideration of limiting the scope of practice (OR 3.08, 1.80-5.20) were both independently associated with higher odds of considering leaving the practice of medicine. The current medicolegal landscape has a profound impact on neurosurgical practice. The fear of being sued, the financial aspects of practicing defensive medicine, and the proportion of neurosurgeons who are considering leaving the practice of medicine emphasize the need for a shift in the medicolegal landscape to a system in which fear of being sued does not play a dominant role and the interests of patients are protected.

A Better World in the Future

A Better World in the Future

Associations Over Time Between Paid Medical Malpractice Claims and Imaging Utilization in the United States.

The aim of this study was to explore state-level relationships between the incidence and payout amounts for medical malpractice claims and Medicare imaging utilization and spending across the United States. Using claims data from a 5% sample of Medicare beneficiaries for 2004 to 2016, annual state population-adjusted rates of imaging utilization and spending were calculated. Using National Practitioner Data Bank files, all paid physician malpractice claims were identified, and lagged state population-adjusted rolling averages of paid claim frequencies and payout amounts were calculated. Controlling for secular trends and state fixed effects with robust standard errors clustered at the state level to account for serial autocorrelation, associations between imaging utilization and lagged paid malpractice claims were assessed using multivariate regression models. Log-log model specification was used to obtain elasticity measures. Between 2004 and 2016, national Medicare diagnostic imaging utilization and spending declined by 31.4% and 47.2%, respectively (from 355,057 to 243,517 examinations and from $28,591,146 to $15,099,291 per 100,000 beneficiaries). Overall national paid malpractice claims and payout amounts declined by 46.4% and 39.6%, respectively (from 4.83 to 2.59 claims and from $1,803,565 to $1,089,112 per 100,000 population). After controlling for secular trends and state fixed effects, advanced imaging utilization was positively associated with the lagged number of per capita paid malpractice claims. Each 1% increase in average paid malpractice claims was associated with a subsequent 0.20% increase in advanced imaging utilization (P= .001). Positive associations between paid malpractice claims and advanced Medicare imaging utilization support the contention that US physicians use medical imaging as a defensive medicine strategy.

An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank.

To describe malpractice payments made on behalf of otolaryngologists, analyze trends over time, and test the association of payment amount with severity of alleged malpractice and patient age. Retrospective cross-sectional analysis. National Practitioner Data Bank. This study comprised all payments made on behalf of otolaryngologists from 1991 to 2018 that were reported to the National Practitioner Data Bank. Descriptive statistics were calculated within and across years. Trends in payments were analyzed with the Mann-Kendall test. Generalized linear regression was utilized to test for association of payment amount with severity of the alleged injury and patient age. From 1991 to 2018, there was a significant decrease in the number of payments (272 to 81) and number of otolaryngologists on whose behalf payments were made (250 to 77). Mean and median payments increased significantly from $248,848 to $420,386 and from $96,813 to $275,000, respectively. By severity of alleged injury, mean payments ranged from $39,755 (95% CI, $20,957-$75,412) for insignificant injury to $754,349 (95% CI, $624,847-$910,692) for patients who were left quadriplegic, sustained brain damage, or required lifelong care. By patient age, mean payments for patients ≥60 years old were $191,465 (95% CI, $159,880-$229,292) versus $247,878 (95% CI, $209,416-$293,402) for patients aged 20 to 39 years and $232,225 (95% CI, $197,691-$272,793) for patients aged 40 to 59 years. The annual number and total value of malpractice payments decreased, while the annual mean and median payments increased. Payment amount was associated with severity of alleged malpractice and patient age.

Differences between Licensed Healthcare Professionals with Substance Use-Related Licensure Discipline

Background Substance Use Disorder (SUD) is a significant public health concern in the United States and healthcare providers are not immune to this disease. The potential for patient harm presented by an impaired provider is the reason SUD in licensed healthcare professionals is a regulatory issue. Aim: This research study seeks to identify the differences in the disciplinary action taken among pharmacists, physicians, and nurses (LPN & RN) in 24 states. Methods: A retrospective secondary data analysis was performed using the public use data file of the National Practitioner Data Bank (NPDB). Inclusion data were grouped and recoded to analyze using Chi-square to compare differences between groups. Results: Nurses are revoked and fined at much higher rates than medicine. Nurses and pharmacists are placed on probation at higher rates than medicine, and medicine was censured more than their nursing and pharmacy colleagues. Conclusions: Licensed healthcare professionals are punished differently for similar SUD-related offenses. Further research should explore these differences to identify evidenced based ways to protect the public while assisting this special at-risk population to recover from SUD.

Using Big Data Analytics to Identify Dentists with Frequent Future Malpractice Claims.

Healthcare spending has been growing at an increasing rate in the US, due in part to medical malpractice costs. Dental malpractice is an area that has not been studied in depth. Using National Practitioner Data Bank (NPDB), we explored the extent of dental malpractice claims and sought to construct a predictive model that can help us identify dental practitioners at risk of performing medical malpractice. Over 1,500 dental malpractice claims were reported annually, and over $1.7 billion being paid out by medical malpractice insurers over the past 15 years. Majority of claims resulted in minor injuries, and the number of major injury claims increased over years. In prediction, we randomly split the data into train (75%) and test (25%) datasets. We trained and tuned models using 5-fold cross validation on the training set. Then, we fitted the model on the test data for performance measures. We used Logistic Regression, Random Forest (RF) and XGBoost and tuned the hypermeters of models accordingly through grid search and cross validation. XGBoost was the best machine learning model to predict the risk of dentists having several malpractice reports. The best performing model had an accuracy of 72.8% with 30.6% F1 score. The NPDB database is a valuable dataset to study dental malpractice claims. Further analysis of information extracted from this dataset is warranted.