Urological Malpractice: Claim Trend Analysis and Severity of Injury.

Introduction: In the current malpractice environment all urologists are at risk. Claim trend data on costs, types of urological errors and severity of injury in urological surgery malpractice claims are lacking.

Methods: We analyzed physician level claim data from a large professional liability insurer with a nationwide client base. Available data included records on closed malpractice claims from 1985 to 2013. We evaluated insured demographics, total number of closed claims, costs of indemnity payments, costs of defense, types of errors resulting in closed claims and severity of injury in urological claims.

Results: Compared to other medical specialties urology ranks 13th in total claims and 15th in average cost of indemnity payments in the last decade. Most urological claims are dropped, dismissed or withdrawn without indemnity payment. Of closed urological claims 27.2% result in an indemnity payment to the plaintiff. Adjusting for inflation, urological indemnity payments have increased by 60% since the 1980s and average payouts are now greater than $350,000. Improper performance of a procedure is the most prevalent urological error resulting in closed claims (875 closed claims in the last decade). Procedures involving the kidney (245 closed claims) and prostate (244 closed claims) are most frequently implicated. The majority of urological errors result in temporary or minor permanent injury. Errors resulting in grave injury are the most costly, with average indemnity payments of $514,844.

Conclusions: Awareness of claim trends and errors implicated can help urologists better understand the current malpractice environment.