Document Detail

Liability associated with obstetric anesthesia: a closed claims analysis.
MedLine Citation:
PMID:  19104180     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the American Society of Anesthesiologists Closed Claims database. METHODS: Obstetric anesthesia claims for injuries from 1990 to 2003 (1990 or later claims; n = 426) were compared to obstetric claims for injuries before 1990 (n = 190). Chi-square and z tests compared categorical variables; payment amounts were compared using the Kolmogorov-Smirnov test. RESULTS: Compared to pre-1990 obstetric claims, the proportion of maternal death (P = 0.002) and newborn death/brain damage (P = 0.048) decreased, whereas maternal nerve injury (P < 0.001) and maternal back pain (P = 0.012) increased in 1990 or later claims. In 1990 or later claims, payment was made on behalf of the anesthesiologist in only 21% of newborn death/brain damage claims compared to 60% of maternal death/brain damage claims (P < 0.001). These payments in both groups were associated with an anesthesia contribution to the injury (P < 0.001) and substandard anesthesia care (P < 0.001). Anesthesia-related newborn death/brain damage claims had an increased proportion of delays in anesthetic care (P = 0.001) and poor communication (P = 0.007) compared to claims unrelated to anesthesia. CONCLUSION: Newborn death/brain damage has decreased, yet it remains a leading cause of obstetric anesthesia malpractice claims over time. Potentially preventable anesthetic causes of newborn injury included delays in anesthesia care and poor communication between the obstetrician and anesthesiologist.
Joanna M Davies; Karen L Posner; Lorri A Lee; Frederick W Cheney; Karen B Domino
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  110     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-9     Citation Subset:  AIM; IM    
Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195, USA.
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MeSH Terms
Anesthesia, Obstetrical / adverse effects*
Anesthesiology / legislation & jurisprudence,  trends
Infant, Newborn
Insurance Claim Review / legislation & jurisprudence*,  trends
Insurance, Liability / legislation & jurisprudence*,  trends
Malpractice / legislation & jurisprudence,  trends
Young Adult
Comment In:
Anesthesiology. 2009 Jan;110(1):8-9   [PMID:  19104161 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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