UROLOGIC MALPRACTICE IN THE UNITED STATES OF AMERICA: TRENDS AND ANALYSIS

Summary

The possibility of a medical malpractice lawsuit is present in the practice of modern day medicine, both in the USA and in other countries. A basic knowledge of trends, monetary values and types of claims involved in urologic litigation is beneficial to the practicing surgeon.

Methods:
A review and analysis of recent publications in the USA was performed. Specific analysis of claims data from 1985–2007 from more than 20 member companies of the Physician Insurers Association of America (PIAA) was also completed. In the PIAA data twenty-eight medical specialties are represented in 230,000 claims. An analysis of urological claims with regard to other specialties, trends, most prevalent and types of procedures was undertaken.

Results:
Within the PIAA data analysis, urology ranks 12th of 28 in the number of claims reported (5,577) and monies paid, totaling 208 million EUR (5 million US) over 22 years. The average urology paid claim from 1985 to 2007 was 126.945 EUR (4,245) which is less than the average of all groups, 148.818 EUR (4,268 US). In 2007 the average indemnity paid was 165.990 EUR (7,838), which is an increase from 128.378 EUR (6,213 US) in 1997. The two most prevalent medical misadventures were improper performance and diagnostic errors which accounted for 51% of all of claims.

Conclusions:
According to the PIAA data, urology as a specialty tends to be at or below average in comparison to other medical specialties in regards to total claims, total monies paid and average monies paid over the last ­23 years. From 1997–2007 the average indemnity paid increased by 23%. Improper performance, ­diagnostic errors and failure to monitor cases resulted in the most lawsuits. Within those groups, malignancy of the prostate, testis, and kidney consistently appeared. Continued analysis, review, and education of the medical litigation in urology can aid in increased awareness and possible improved care for patients in the future.

Kex words:
urologic medical malpractice, missed diagnosis, costs medical malpractice