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Pediatric ophthalmologists pay most in malpractice suits, review finds

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WAIKOLOA, Hawaii — About 95% of ophthalmologists are sued for malpractice over a 35-year career, and pediatric ophthalmologists make the highest indemnity payments, a speaker told colleagues here.

“Malpractice lawsuits are very common but quite variable depending on what specialty you are in,” Judy E. Kim, MD, said at Retina 2016. “It’s not a matter of if you get sued. It may be a matter of when you’re going to get sued.”

Judy Kim

According to the Physician Practice Survey conducted by the American Medical Association in 2007 and 2008, 42% of respondents had been sued at least once and 20% had been sued at least twice, Kim said. General surgeons (90%) and obstetrician/gynecologists (50%) were sued the most, she said.

In a 5-year review of Ophthalmic Mutual Insurance Company (OMIC) data of 218 malpractice cases between 2008 and 2012 that closed with indemnity payments of $40.5 million, general ophthalmologists, representing almost 59.5% of those insured, paid the most — $17,870,000 — with the average payment being $175,196. Medical and surgical retina specialists, representing 17% of those insured, paid $4,972,000 at an average of $248,600 per case. Pediatric ophthalmologists, however, representing only 4.39% of those insured, paid the most, an average of $874,600. Failure to diagnose retinopathy of prematurity, by either a pediatric ophthalmologist or a medical retina specialist, incurred some of the greatest losses, more than $1 million in four cases, Kim said.

In a 10-year review of OMIC data, Kim and colleagues found 344 of 2,246 (15%) closed claims handled between 2003 and 2012 involved retina specialists. Of those 344 claims, 43 (13%) involved indemnity payments. Eleven cases went to trial; 10 verdicts were in favor of the defendant and one case ended in a settlement, Kim said. In that review, the average indemnity payment from retina specialists was $275,898.

Malpractice suits against retina specialists most often involved alleged negligent treatment of retinal detachment, negligent vitrectomy, and failure to diagnose or failure in diagnosing retinal detachment, Kim said.

“Talk about what happened,” she said. “It’s the patients who think that you did something wrong and yet cannot get the answer, those are the patients who get frustrated and they may go on to a lawsuit rather than if you were to say, ‘Mrs. Smith, this is what happened and I’m sorry. We did our best but this is where we are.’ They are less likely to sue.” – by Matt Hasson and Patricia Nale, ELS

Reference:

Kim JE: Malpractice claims associated with retina specialists: who gets sued and how to avoid. Presented at: Retina 2016; Jan. 16-22; Waikoloa, Hawaii.

Disclosure: Kim reports no relevant financial disclosures.