STEAMBOAT SPRINGS, COLO. – The good news for pediatricians on the malpractice front is they get sued far less often than other specialists.
The bad news? When a pediatrician does have an indemnity payout, it’s a whopper, according to Dr. Steven M. Selbst, professor and vice chair of pediatrics at Jefferson Medical College, Philadelphia, and author of a textbook on preventing malpractice lawsuits in pediatric emergency medicine.
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Although pediatricians aren’t sued that often, a study shows that their average indemnity payouts are the highest out of 25 specialists.
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He pointed to the findings of a landmark study of medical malpractice which concluded that pediatricians had the highest average indemnity payouts out of any of the 25 specialties scrutinized. The mean payment in successful lawsuits involving pediatricians was $520,924, nearly twice the average of $274,887 for physicians overall, he said at a meeting on practical pediatrics sponsored by the American Academy of Pediatrics.
Indeed, the average indemnity payment for pediatricians was, surprisingly, substantially greater than for neurosurgeons or cardiothoracic surgeons, widely considered to be the highest-risk practitioners.
On the plus side, pediatricians had the second-lowest risk of being sued among all physician specialties. A mere 3.1% of pediatricians per year faced a malpractice claim, compared with 19.1% of all neurosurgeons, 18.9% of cardiothoracic surgeons, and 15.3% of general surgeons. Only psychiatrists had a lower annual risk of being sued than pediatricians, he said.
The study, funded by the RAND Institute for Civil Justice and the National Institute on Aging, encompassed one large insurance company’s malpractice lawsuit data for 1991-2005. It included nearly 41,000 insured physicians in all 50 states, among whom were 1,616 pediatricians. Each year, on average 7.4% of all physicians were the subject of a malpractice claim, and 1.6% of physicians had a claim resulting in a payout. In other words, 78% of malpractice claims did not result in payment to the claimant. The investigators calculated that by age 65 years, 75% of physicians in pediatrics and other low-risk specialties would face a malpractice claim, as would 99% of neurosurgeons and other high-risk practitioners (N. Engl. J. Med. 2011;365:629-36).
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Dr. Steven M. Selbst
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Dr. Selbst said that among the reasons lawsuit payouts are so large in pediatrics is that juries tend to be extremely sympathetic to plaintiffs injured in childhood. And, when damages are calculated in such cases, the tally will include potential lost income for the rest of that child’s life.
"We’re also at great risk because the statute of limitations is longer in pediatrics. For most other patients, it’s 2 years after the injury. But in pediatrics it can take a long time to recognize the injury. If a patient has developmental delay, it may not be recognized until they’re in school, so it could be 5-10 years later. And even if the family didn’t want to file a lawsuit, when the child becomes 18 years old he or she can file," explained Dr. Selbst.
"There are lawsuits out there dating from an injury at the time the child was a neonate, and he’s now 18 years old. So the statute of limitations in pediatrics can be 20 years. I think that’s a reminder that you have to keep your medical records, somehow, some way, pretty much forever, but at least for 21 years. You can be named in a lawsuit many, many years later," he emphasized.
Dr. Selbst reported having no financial conflicts.
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