When people think about medical malpractice claims, they commonly worry about surgical errors where tools are left inside the patient, wrong site procedures, or medical charts being lost or misinterpreted. Despite the specter of harmful mistakes within the hospital setting (i.e. inpatient procedures), a surprising number of medical malpractice claims arise from outpatient treatment.
A recent study by the Journal of the American Medical Association (JAMA) found that nearly half of the 10,739 malpractice claims paid in 2009 stemmed from outpatient treatments. Major injuries and deaths accounted for a majority of claims in both settings. Naturally, surgical events caused the bulk of inpatient events, while diagnosis related claims led to a large proportion of outpatient claims. Payments for inpatient claims were significantly higher. The average payout was $362,965, compared to $290,111 for outpatient claims.
In the last five years, a number of initiatives have focused on patient safety in the inpatient setting. For example, more hospitals are following the confirmation protocols set forth by the U.S. Joint Commission in 2003. Nurses confirm the patient's identity and mark the site for the surgery at a pre-procedure check-in. Before administering anesthesia, another confirmation takes place. Before the surgery, all team members are introduced to the patient, and the surgeon discusses the procedure and all routine and non-routine steps to be anticipated. These steps became especially important when Medicare stopped paying hospitals when surgical mistakes were made.
However, the number of invasive, complicated procedures performed in the outpatient setting has also increased. According to the JAMA study, patients have 30 times more outpatient visits than hospital discharges each year. With more procedures being handled outside of the traditional hospital setting, patient safety measures must also be advanced for outpatient care.
Critics of the report question the feasibility of incorporating safety initiatives in the outpatient setting. They believe it will be more difficult to do so because there are so many more outpatient care sites that may not have enough trained staff members to execute safety protocols. Nevertheless, the increasing cost of medical malpractice claims should inspire greater care for patient safety in these venues.
If you have questions about the legal implications of medical malpractice in outpatient settings, an experienced attorney can advise you.