TITLE:
Anesthesia Related Closed Claims and Litigations at the Detroit Medical Center: Analysis, Lessons Learned, and Conclusions
AUTHORS:
Kris Ferguson, Jason Young, Peter Panagopoulos, Philip Khoury, George M. McKelvey, Samir F. Fuleihan, Walid A. Osta
KEYWORDS:
Anesthesia, Closed Claims, Complications, Litigations, Malpractice, Negligence
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.4 No.4,
April
2,
2014
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.