THE RELATIONSHIP BETWEEN MALPRACTICE CLAIMS HISTORY AND SUBSEQUENT OBSTETRIC CARE

Objective.-To determine the relationship between prior malpractice cla ims experience and the quality of clinical obstetric care. Design.-His torical cohort study of obstetricians, classified by their prior malpr actice claims experience, with blinded review of medical records from their practices 5 to 10 years later. Setting.-Florida obstetricians wh o lost, settled, or defended malpractice claims between 1977 and 1983 and who were still practicing obstetrics in 1987. Main Outcome Measure s.-Objective and subjective assessment of quality of clinical care of patients attended by obstetricians with different histories of malprac tice claims. Results.-No differences were found in any of the objectiv e or subjective measures of the quality of clinical care provided to p atients of obstetricians who were classified into one of four groups a ccording to their prior claims history. Conclusions.-No relationship w as found between prior malpractice claims experience and the technical quality of practice by Florida obstetricians. Strategies that attempt to identify physicians at risk for future clinical errors by using da ta on prior malpractice claims (such as the National Practitioner Data Bank) may be misjudging the likelihood that substandard clinical care will be provided by physicians with prior claims.