Diagnostic Errors Are Top Claims in Medical Malpractice Suits Involving Children

Misdiagnoses and other diagnostic errors are the basis of more medical malpractice lawsuits involving young children than any other claim, a recent study shows.

In its Study of Malpractice Claims Involving Children, The Doctors Company, the nation’s largest physician-owned malpractice insurer, reviewed over 1,200 claims filed on behalf of pediatric patients between the ages of 1 to 17 which were resolved between 2008 and 2017. Analyzed claims were filed against doctors practicing in more than 50 specialties and sub-specialties.

Of the 1,200+ claims, researchers found the single most common claim alleged in medical malpractice suits to be a missed, failed, or wrong diagnosis. Accounting for 34 to 44 percent of all claims filed on behalf of children over the age of 1 month, and being the second-most common claim in suits involving infants under 1 month, these diagnostic errors typically resulted from inadequate medical assessments.

Other Key Findings From the Study:

Pediatric Physicians Implicated in Claims – With the exception of dentists and oral surgeons, the study saw claims filed against 52 different types of specialists. The top 10 physicians named in reviewed medical malpractice lawsuits, however, comprised nearly 3/4 of all pediatric patient claims. Some of the top specialties named in these claims included:

• Obstetrics (24%)
• Pediatrics (15%)
• Orthopedics (7%)
• Emergency Medicine / Family Medicine (6%)
• Radiology / General Surgery / Anesthesiology (3%)

Plaintiffs – Pediatric patients involved in the claims reviewed by researchers were spread evenly across four pediatric age groups: neonatal (under 1 year), first year, child, and teenager. These patients were most often treated in the following locations:

• Neonatal – Labor and deliver (60%)
• First Year – Doctor’s office / clinic (45%) or hospital room (14%)
• Child (1-9) – Doctor’s office / clinic (37%) or ER department (14%)
• Teens – Doctor’s office / clinic (40%), ambulatory surgery (16%), or ER (12%)

The study reported that approximately just over a third of all claims resulted in payments to victims, with a median indemnity payment ranging from under $129,000 for claims involving teens to about $300,000 for suits involving the youngest infants. Researchers also dug into when these claims were filed:

• Over 75% of claims were filed within 3 years of the underlying event;
• By 5 years, 85% of claims were filed; and
• Nearly 97% of claims were filed before 10 years had passed.

Injuries / Injury Severity – The study charted a significant amount of data on the types and severity of injuries involved in these medical malpractice cases. For example, researchers noted:

• Brain Injuries – The Brain was the most commonly injured body part across all pediatric groups, which suggests high rates of brain damage, asphyxia, and other similar birth injuries, as well as surgical complications, traumatic injuries, and more.
• Injury Severity – Severity of injury ranged from age group to age group, with younger patients suffering the most severe injuries at higher rates when compared to older children and teens.
• Wrongful Death – Pediatric death occurred in 13% of claims involving neonatal patients, nearly a third of claims for children in their first year of life, 15% for children between the ages of 1 to 9, and 13% of claims involving teens.
• Contributing Factors – Patient assessment issues were the most common contributing factor to injuries among all pediatric patients. These types of issues involve injuries resulting from treating medical professionals who did not consider important information, such as the failure to approximate fetal size and weight prior to delivery, which can increase risks of preventable birth injuries. Other examples include failures to order to delays in ordering diagnostic tests, inadequate patient history, misinterpreting diagnostic exams, and over-reliance on negative findings in test results. Selection and management of therapy, provider communication issues, technical performance, and lack of documentation were also common contributing factors to injuries across all age groups.

Victims’ Claims – As mentioned, the most common underlying reason for a medical malpractice claim involving children related to misdiagnosis, failure to diagnose, and other diagnostic errors. There were, however, other allegations in these claims, as well as a different spectrum of allegations in different patient age groups:

• Neonatal patients – Obstetrics-related care (i.e. pregnancy, labor, delivery) comprised 63% of all neonatal patient claims, diagnostic errors 14%, non-obstetric medical treatment 13%, and surgical treatment 4%.
• First year – Patient in their first year of life had claims involving diagnostic errors (44%), non-obstetric medical treatment (21%), surgical treatment (8%), patient monitoring (3%) and others.
• Child (1 -9) – The most common allegations for children ages 1 through 9 involved diagnostic errors (38%). The next leading claims were non-obstetric medical treatment (22%), surgical treatment (22%), communication (6%), and improper medical management (4%).
• Teens – Diagnostic errors were also the most common claim among teens, accounting for just over a third of all claims. Surgical treatment (23%), medical treatment (19%), improper medical management (6%), and anesthesia-related treatment (4%) were the next most common claims.

Diagnostic Errors – Diagnostic errors were the most common underlying claims for child patients all but the neonatal age group, which still cited diagnosis-related allegations in 14% of claims. The most common diagnosis-related allegations involving:

• Neonatal patients – Kernicterus (birth injury), infections, and ventricular septal defect.
• Older age groups – Fractures and dislocations, pneumonia and meningitis, appendicitis, infections (MRSA and viral / bacterial infections), and cardiac conditions.

Trends – Because the study reviewed claims which had been filed and resolved between 2008 and 2017, researchers were also able to chart data for the purposes of mapping medical malpractice trends. Their findings included:

• A General decrease in delayed treatment in response to fetal distress over a 10-year period, until it increased in 2015 and 2016.
• Medical malpractice allegations arising from labor and delivery (i.e. brain damage caused by forceps or vacuum extractors, brachial plexus caused by shoulder dystocia, etc.) decreased in neonatal claims since its high in 2011,
• Diagnostic errors were a leading medical malpractice claim throughout each year of the study, ranging from 29% to 47% over 10 years.

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Although the study was conducted by a medical malpractice insurer with only a finite number of claims, it does provide a great deal of insight into what medical malpractice lawsuits involving children look like – at least in terms of underlying issues, forms of medical negligence, and injury types. What the study doesn’t show, is how profoundly victims and families can suffer as a result of preventable injuries.

Spangenberg Shibley & Liber LLP has been named about U.S. News’ Tier 1 rankings for “Best Law Firms” in the nation in Medical Malpractice and Personal Injury Litigation. Our success in this field has been driven our talented and highly experienced resources, our ability to leverage resources and professional connections to tackle complex issues, and our willingness to fight aggressively for the justice and compensation our clients and their families deserve.

If you have questions about a medical malpractice or birth injury claim of your own and how our Cleveland-based attorneys may be able to help you with a potential case anywhere in Ohio, call (216) 600-0114 or contact us online. Consultations are free and confidential.