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Pediatrician Malpractice Insurance

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While pediatrics is not considered a high-risk specialty, and pediatricians are sued less than other physicians, approximately 33 percent of pediatricians are sued in their career. When a pediatrician is sued for negligence, the case is often more difficult to defend because of the sympathy factor that is always present regardless of the facts of the case. And because injured children live longer today due to medical advances, the life care plans put forth by plaintiff’s counsel can often result in very large settlements and verdicts. Noneconomic damage caps do not help much when the plaintiff is a severely injured child.

Pediatrician Malpractice Insurance Rates

Pediatrician malpractice rates are fairly similar to those of family practitioners due to the fact that neither specialty carries any real extraordinary risk. Rates run less than $10,000 per year in states like Idaho up to around $50,000 in areas like Miami, Fla., and around $40,000 in Chicago, IL.

The Role of Diagnostic Errors in Pediatric Malpractice

A recent study published in Pediatrics, the official journal of the American Academy of Pediatrics, found that the only type of medical care in which children were more likely than adults to experience a potentially preventable malpractice-related event involved diagnostics. Inadequate communication is most frequently the root cause of diagnosis error.

Failure to diagnose—or a misdiagnosis of—meningitis, appendicitis or congenital anomalies can lead to serious adverse outcomes. Another common reason is improper performance of procedures that include diagnostic consultations, non-operative procedures, prescriptions, general physical examinations as well as injections and vaccinations. Pediatricians should have risk management policies and procedures that first eliminate these more common diagnostic errors prior to moving forward with a patient assessment.

Effective Risk Management Can Reduce Adverse Outcomes

Risk management guidelines that increase communication can decrease errors related to diagnosis and thereby decrease a pediatrician’s liability exposure. When formulating risk management strategies for pediatric patients, it is important to take into account the patient’s ability to communicate their symptoms (especially when the patient is of an age where they cannot communicate with caregivers) as well as have a firm comprehension of the symptoms relating to the most misdiagnosed pediatric illnesses—such as meningitis and appendicitis.

Verbal and nonverbal signals can create an initial impression that can either facilitate or undermine the communication process. Most pediatricians have been trained to assess their patients through a combination of the child’s self-reporting and observation of behavioral, psychological and biological responses. However, this process must extend beyond the patient. Parents who perceive that the physician is distracted, trying to rush dialogue or is not valuing the parent’s input, can feel as though there is an adversarial relationship being fostered between parent and doctor. This tension can hinder the clinician’s efforts at diagnosis as well as foster a more litigious attitude should there be an adverse outcome.

Another recent study conducted by Glenn S. Takata, MD, and published in the April 2008 issue of Pediatrics identified an “11.1 percent rate of adverse drug events in pediatric patients.” The study also concluded “22 percent of those adverse drug events were preventable, 17.8 percent could have been identified earlier and 16.8 percent could have been mitigated more effectively.”

Children are more susceptible medication errors because drug dosages for children are calculated on a per weight basis that is significantly different from calculating dosages for adults. A computation error can result in significant under or over-dosage. One of the frighteningly common medication safety issues in regard to children is the “ten-fold error,” where a misplaced decimal point can lead to a ten-fold change in the appropriate dosage of medication).

Key to pediatricians avoiding malpractice lawsuits hinge on patient-physician-parent communication and accuracy when prescribing medication. Both hazards can be mitigated when proper diligence is placed upon formulating risk management policies and procedures to eliminate these errors.


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