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Understanding Dropped, Denied, and Dismissed Malpractice Cases

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Understanding Dropped, Denied, and Dismissed Malpractice Cases

By Jock Hoffman, CRICO

Related to: Ambulatory, Claims, Communication, Emergency Medicine, Primary Care, Obstetrics, Other Specialties, Surgery

Last month we noted that 72 percent of 46,000 medical malpractice cases analyzed were dropped, denied, or dismissed without a trial or settlement. More specifically:

 

The claimant abandons (drops) the claim, which is subsequently closed by the insurer; or
 
Based on an investigation of the (pre-suit) claim, it is denied by the professional liability insurance provider covering the caregivers; or
 
A formal complaint or lawsuit is subsequently dismissed—either voluntarily by the plaintiff, or by a court order.

 

Analysis of the 16,646 fully-coded CBS cases closed with a dropped/denied/dismissed designation indicates that 33 percent involve a serious (i.e., high-severity) injury or death. Most commonly, the cases that are eventually closed by being dropped, denied, or dismissed, allege a surgical error (30%), mismanagement of medical treatment* (24%), or a misdiagnosis (20%).

Anticipating Potential Cases

Understanding what factors commonly cause a claimant to first file, then shift away from, a formal allegation of medical malpractice may help caregivers, risk managers, and patient advocates pre-empt such actions while still attending to patients’ needs and frustrations. CRICO’s exploration of what indicators might alert clinicians or risk managers to a case that lacks evidence of substandard practice or negligence is ongoing.

One of the more likely sources of such cases, however, is those patients who have suffered from a known complication of a procedure or treatment regimen. Their distress over the outcome—and at being the “1 out of X” who suffers such a complications—can trigger the need to find out “why me,” via an allegation of malpractice. Health care providers with systems that can identify patients in that circumstance may be able to avert the emotional and financial costs (approximately $22,000 in expenses) of a malpractice claim or suit that will sooner or later be dropped, denied, or dismissed.

 

*Mismanagement of medical therapy or a non-surgical procedure

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June 24, 2015
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