Overview of Pediatric Risk Management
April 17, 2018 | Healthcare Risk, Quality, & Safety Guidance
Pediatric medicine tends to be a low-risk specialty from a claims frequency perspective, ranking 25th of 26 specialties (Jena et al. "Malpractice Risk according to Physician Specialty"). In 2013, the chance that a pediatrician would be sued in a given year was 3.1%, compared with 7.4% across all specialties (Jena et al. "Malpractice Risk among US Pediatricians"). However, the severity of claims asserted in pediatrics is extremely high. For certain conditions (e.g., meningitis), the probability that a claim will be resolved with payment may also be higher than for the average medical malpractice claim. The average medical malpractice indemnity payment across all specialties has been reported at $361,340, and the rate of claims resolved without payment is 74%. (Brockway and Wenske) See Table. Claims with Payout and Average Indemnity Payments in Pediatrics for details.
Claims may be particularly severe in pediatrics for several reasons. The child may require expensive care for a long period for a permanently disabling injury, and permanent disability reduces the child's future earning capacity. Also, juries tend to be sympathetic to a disabled child who is either physically or cognitively impaired. If the child died, monetary recoveries from a jury trial may be high.
Pediatric claims data also skew by age. One study looked at the ages of patients involved in claims and found that 49% of cases involved children who were less than 1 month old; 24.8% involved children who were between 1 and 12 months old; and 26.2% involved children who were older than 1 year (Jena et al. "Malpractice Risk among US Pediatricians").
Sources: Jena AB, Chandra A, Seabury SA. Malpractice risk among US pediatricians. Pediatrics 2013 Jun;131(6):1148-54. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23650293 doi: 10.1542/peds.2012-3443; Physician Insurers Association of America. Most common patient conditions in pediatric malpractice claims average indemnity. Pediatric claims closed 1985-2011. 2012 cited 2018 Feb 16.
While this guidance article is not a primer on how to practice pediatric medicine, certain conditions pose an extremely high degree of risk. Many of the most serious conditions manifest themselves as common conditions in children, and only show themselves as emergencies when the margin for error has gotten distressingly narrow. If the practitioner and staff are aware of the factors that place one patient...