Comparing 20 years of national general surgery malpractice claims data: obesity versus morbid obesity.

Background: We hypothesized that the increasing body mass index of the population has affected general surgery malpractice claims.

Methods: We queried the Physician Insurers Association of America database from 1990 to 1999 (ie, period 1) and 2000 to 2009 (ie, period 2) for claims associated with obesity and morbid obesity. We analyzed the error involved, injury severity, procedure, and outcome.

Results: Five hundred seventy-five claims were identified. The percentage of paid claims did not differ by body mass index. Improper performance was the most common alleged error, gastric bypass was the most common procedure, and death was the most common injury. For obesity claims, the case was more likely to be settled in period 1 and withdrawn/dismissed in period 2 (P < .001). The number of morbid obesity claims rose from 9 in period 1 to 249 in period 2.

Conclusions: The significant rise in morbid obesity claims between periods is likely caused by the substantial increase in the number of bariatric procedures performed.