Medical professional liability insurance closed claim annual report

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The Oklahoma Insurance Department (OID) hereby presents composite data of medical professional
liability closed-claim reports for 2010.
The Department publishes this report pursuit to Title 36, Section 6813 of the Oklahoma Statutes. This report contains aggregate numbers from statewide closed-claims data. Information about
specific closed claims is confidential pursuant to Title 36, Section 6816, and is unavailable for public inspection.
The OID has established procedures to collect these claim reports and produce this final composite report. However, the closed-claim reports submitted to the Insurance Department are completed without any type of affirmation of accuracy by the insurer. The OID makes neither final nor absolute guarantee about the information contained in this report. This information should not be viewed as a substitute for any type of financial or actuarial opinion about a reporting insurer’s claims activities.
The OID collects unedited data from reporting insurers and presents the final aggregate numbers in this annual report. The Department continues to work with the Oklahoma Legislature and with others in the state to more accurately define the statutory requirements and enhance data collection and understanding.
Questions applicable to this report should be directed to:
Denise M. Engle, CPCU, CPIW, AIC
Deputy Commissioner of Workers’ Compensation
denise.engle@oid.ok.gov
Five Corporate Plaza
3625 NW 56th, Suite 100
Oklahoma City, OK 73112-4511
1-800-522-0071
OKLAHOMA INSURANCE DEPARTMENT
MEDICAL PROFESSIONAL LIABILITY INSURANCE
CLOSED CLAIM ANNUAL REPORT
JANUARY 1, 2010 – DECEMBER 31, 20103
Insurance Policy Limits ($) Closed Claim Count Medical Speciality Providers Count
100,000 1 Anesthesiology 1
125,000 11 Cardiovascular diseases 25
200,000 1 Dermatology 5
250,000 13 Diagnostic Radiology 1
500,000 13 Emergency medicine 43
750,000 2 Gastroenterology 3
1,000,000 486 General / Family Practice 57
2,000,000 86 General preventive medicine 1
3,000,000 17 Hospitalist 2
5,000,000 42 Internal medicine 29
9,000,000 2 Neurology 5
10,000,000 9 Neurology - clinical neurophysiology 2
23,000,000 1 Nuclear medicine 1
Obstetrics & Gynecology 47
Ophthalmology 9
Otolaryngology 3
Pediatrics 9
Insurance Policy Limits ($) Closed Claim Count Psychiatry 2
unknown or not applicable 49 Physical medicine & rehabilitation 1
300,000-750,000 4 Pulmonary diseases 5
1,000,000 80 Radiology 29
2,000,000-2,250,000 23 General surgery 18
3,000,000 419 Neurological surgery 11
4,000,000 69 Orthopedic surgery 30
4,500,000-10,000,000 33 Plastic surgery 10
23,000,000-31,500,000 7 Thoracic surgery 8
Urological surgery 1
General dentistry (no specialty) 40
Other specialty-not classified/ Unspecified/Unknown
286
INSURANCE CLOSED CLAIM ANNUAL REPORT 2010
The policy limits of the medical professional liability
insurance policy covering the claim:
Per occurrence policy limits, primary coverage.
The policy limits of the medical professional liability
insurance policy covering the claim:
Annual policy limits, primary coverage.
The medical specialty of the provider who was primarily responsible for the medical malpractice incident that led to the claim.
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Type of Health Care Facility Closed Claim Count
Chiropractic Group / Practice 7
Dental Group / Practice 42
Optician/ Optometric Group /
Practice 5
Podiatric Group / Practice 3
Medical Group/ Practice 62
Mental health / Substance
Abuse Group / Practice 4
General/Acute Care Hospital 399
Psychiatric Unit 2
Nursing Facility/Skilled Nursing
Facility 15
Adult Day Care Facility 1
Residential Treatment Facility/
Program 3
Ambulatory Surgical Center 18
Ambulatory Clinic/ Center 17
Health Center/Federally
Qualified Health Center/
Community Health Center 2
Rural Health Clinic 5
Radiology/Imaging Center 9
Blood Bank 1
Pharmacy 42
Nursing/Health Care Staffing
Service 3
Ambulance Service/
Transportation Company 3
Other not specified 41
Location within a Facility Closed Claim Count
Catheterization lab 5
Critical care unit 6
Dispensary 1
Emergency department 82
Labor and delivery room 47
Nursery 8
Operating room 159
Outpatient department 9
Patient room 87
Radiation therapy department 3
Radiology department 31
Recovery room 1
Special procedure room 15
Clinical support center - such as
a laboratory or radiology center 1
Office 116
Walk-in clinic 8
Other department in hospital 6
Other/Unknown 99
City Closed Claim Count
Ada 15
Altus 4
Antlers 3
Ardmore 10
Bartlesville 10
Beaver 1
Beggs 2
Bethany 2
Big Cabin 1
Bixby 1
Broken Arrow 8
Chandler 2
Chickasha 7
Claremore 9
Cleveland 2
Clinton 4
Cordell 3
Drumright 2
Duncan 10
Durant 8
Edmond 32
El Reno 1
Elk City 7
Enid 11
Frederick 1
Grove 2
Guthrie 1
Guymon 8
Hartshorne 2
Holdenville 4
Jenks 4
Langley 1
Lawton 40
Locust Grove 1
Madil 1
McAlester 4
Midwest City 5
Moore 5
Muskogee 23
Nichols Hills 1
Noble 1
Norman 32
Oklahoma City 176
Okmulgee 1
Owasso 6
Pauls Valley 1
Pawhuska 2
Ponca City 2
Ringling 1
Sallisaw 1
Sapulpa 2
Seminole 1
Shawnee 9
The type of health care facility where the medical
malpractice incident occurred.
The primary location within a facility where the
medical malpractice incident occurred.
The geographic location, by city, where the medical malpractice incident occurred.
INSURANCE CLOSED CLAIM ANNUAL REPORT 20105
County Closed Claim Count
Adair 1
Beaver 1
Beckham 7
Blaine 3
Bryan 8
Canadian 2
Carter 8
Cherokee 4
Cleveland 36
Comanche 39
Craig 2
Creek 4
Custer 4
Delaware 2
Garfield 11
Garvin 1
Grady 8
Hughes 5
Jackson 4
Jefferson 1
Johnston 2
Kay 2
Kiowa 1
Latimer 1
Lincoln 3
Logan 1
Marshall 1
Mayes 3
Murray 1
County Closed Claim Count
Muskogee 23
Oklahoma 221
Okmulgee 3
Osage 4
Pawnee 2
Payne 11
Pittsburg 6
Pontotoc 14
Pottawatomie 9
Pushmataha 3
Rogers 11
Seminole 1
Sequoyah 1
Stephens 10
Texas 8
Tillman 1
Tulsa 171
Wagoner 2
Washington 8
Washita 3
City Closed Claim Count
Skiatook 1
Stillwater 11
Stilwell 1
Stroud 1
Sulphur 1
Tahlequah 4
Tishomingo 2
Tulsa 153
Vinita 1
Wagoner 2
Watonga 4
Weatherford 1
Wilburton 1
Yukon 1
Unknown 7
The geographic location, by county, where the
medical malpractice incident occurred.
Unknown1%Male42%Female57%
The sex of the injured person on the incident date.
392 286 6
INSURANCE CLOSED CLAIM ANNUAL REPORT 20106
NPDB Code Type of Injury Closed Claim Count
1 Emotional Injury 41
2 Insignificant 80
3 Minor 115
4 Major 77
NPDB Code Type of Injury Closed Claim Count
5 Minor 41
6 Significant 34
7 Major 58
8 Grave 16
The age of the injured person on the incident date.
0%5.00%10.00%15.00%20.00%Unknown19 year olds - 2950 year olds - 5980 +
Age How Many Percentage
Unknown 13 2.00%
Less than one year old 86 12.60%
1 -18 50 7.30%
19-29 56 8.20%
30-39 93 13.60%
Age How Many Percentage 40-49
50-59
60-69
70-79
80+
132 19.30%
88 12.90%
89 13.00%
48 7.00%
29 4.20%
The severity of malpractice injury using the National Practitioner Data Bank severity scale.
TEMPORARY
PERMANENT
9 Death 192
Unknown 30
Settlement information that identifies the final
method of claim disposition.
Settlement information that identifies the timing
of claim disposition.
Method of claim disposition Closed Claim Count
Claim is abandoned by the claimant 325
Claim is settled by the parties 157
Directed verdict for the defendant 5
Directed verdict for the plaintiff 1
Involuntary dismissal 68
Judgment for the defendant 32
Arbitration 1
Mediation 87
Other Type of Alt. Dispute Resolution 5
Unknown - N/A - Coverage Denied 3
Timing of claim disposition Closed Claim Count
Before filing suit or requesting
arbitration or a mediation hearing 121
Before trail, arbitration or mediation 416
During trail, arbitration or mediation 134
After trail or hearing, but before
judgment or award 3
After judgment or decision,
but before appeal 4
After an appeal 1
Unknown 5
INSURANCE CLOSED CLAIM ANNUAL REPORT 20107
The indemnity payment made on behalf of the defendant $1,000,000
Economic damages $1,000,000
Noneconomic damages $0
Punitive damages, if applicable $0
Total Defense and Cost Containment Expense $740,163
Specific information about the indemnity payments and defense and cost-containment expenses for claims disposed of by a court THAT RESULT in a verdict or judgment that itemizes damages.
The total amount of the settlement on behalf of the defendant $49,527,028
The insuring entity’s or self-insurer’s best estimate of economic damages included in the settlement $8,387,734
The insuring entity’s or self-insurer’s best estimate of noneconomic damages included in the settlement $41,678,977
Total Defense and Cost Containment Expense $19,882,787
Specific information about the indemnity payments and defense and cost-containment expenses for claims that DO NOT result in a verdict or judgment that itemizes damages.
The reason for the medical professional liability claim, allegation group.
Reason Closed Claim Count
Diagnosis related 127
Anesthesia related 14
Surgery Related 101
Medication Related 83
IV & Blood Products Related 6
Obstetrics related 46
Reason Closed Claim Count
Treatment related 213
Monitoring related 49
Equipment / Product Related 9
Other / Miscellaneous 24
Behavioral Health 3
Unknown 9
INSURANCE CLOSED CLAIM ANNUAL REPORT 20108
*2010 SUPPLEMENTAL INFORMATION
Number of claims with payment by insurer 214
Number of claims with no payment by insurer 470
Average claim settlement or award with payment by insurer $236,108
Total defense and cost containment expense for claims with payment by insurer $9,968,644
Total defense and cost containment expense for claims with no payment by insurer $10,654,306
Average defense and cost containment for claims with payment by insurer $46,582
Average defense and cost containment for claims with no payment by insurer $22,668
*This supplemental information is provided as a courtesy by the Oklahoma Insurance Department to supplement your Medical Professional Liability Insurance Closed Claim Annual Report and is not required to be furnished by statute.
The reason for the medical professional liability claim, specific allegation.
NPDB Reason Closed Claim
Code Count
100 Failure to use aseptic technique
101 Failure to diagnose
102 Failure to delay case when indicated
103 Failure to identify fetal distress
104 Failure to treat fetal distress
105 Failure to medicate
106 Failure to monitor
107 Failure to order appropriate medication
108 Failure to order appropriate test
110
112
113
200
201
202
203
300
302
303
304
305
306
308
311
312
315
318
319
320
321
322
323
324
NPDB Reason Closed Claim
Code Count
325
326
327
328
330
333
334
402
404
501
502
504
505
601
602
700
701
703
704
706
707
708
711
712
715
717
719
720
899
999
099
Failure to perform procedure
Failure to recognize a complication
Failure to treat
Delay in diagnosis
Delay in performance
Delay in treatment
Delay in treatment of identified fetal distress
Administration of blood or fluid problems
Complimentary or alt. medication problem
Equipment utilization problem
Improper choice of delivery method
Improper management
Improper performance
Improperly performed vaginal delivery
Improper technique
Intubation problem
Medication administered via the wrong route
Patient monitoring problem
Patient position problem
Problem with appliance
Radiology or imaging error
Surgical or other foreign body retained
Wrong diagnosis or misdiagnosis
Wrong dosage administered
Wrong dosage dispensed
Wrong dosage ordered of correct medicine
Wrong medication administered
Wrong medication dispensed
Wrong body part
Wrong patient
Wrong procedure or treatment
Unnecessary procedure
Unnecessary treatment
Failure to instruct or communicate
with patient of family
Failure to report on patient condition
Failure to supervise
Improper supervision
Failure/delay in referral or consultation
Premature discharge from institution
Abandonment
Assault and Battery
Breach of patient confidentiality
Equipment malfunction
Failure to ensure patient safety
Failure to obtain consent / lack of
Failure to protect 3rd party
(Legal, ethical, or moral) improper conduct
Inadequate utilization review
Product liability
Sexual misconduct
Vicarious liability
Wrong life/birth
Cannot be determined from available records
Allegation not otherwise classified
UNKNOWN
4
78
2
12
1
7
23
15
3
3
16
19
43
10
19
2
1
2
5
4
41
126
5
20
4
1
12
1
1
4
18
11
2
9
1
3
27
2
1
8
4
5
12
4
5
7
2
1
1
4
2
1
8
3
1
1
2
3
2
3
1
19
16
11
INSURANCE CLOSED CLAIM ANNUAL REPORT 2010