Urological medical malpractice

Purpose: Like all other medical and surgical practitioners, urologists are occasionally confronted with the unpleasant realization that they are being sued for medical malpractice. These suits are generated through any number of acts or failures to act during innumerable circumstances. We reviewed a ll urological claims presented to 1 representative insurance company and de lineated the types of acts, settings, expenses and disposition of these cla ims. This review was performed to understand better the claims confronting urologists and provide future guidance to urologists in the medical malprac tice setting. Methods and Materials: Working with The St. Paul Companies 259 medical malp ractice claims against urologists consecutively closed from 1995 to 1999 we re reviewed. Claims were defined as urological malpractice when the insured -defendant in a malpractice claim was a urologist. Each claim was reviewed in terms of disposition, patient age, geographic location, office-hospital setting, purported negligent act, procedure if applicable, litigation statu s and expenses incurred. Data ascertained were then compared to national pr actice statistics provided by the American Urological Association (AUA) and American Medical Association. In addition, a literature search with the ke y words urology and malpractice was performed. Related pertinent documents were reviewed and incorporated into this analysis. Results: We reviewed 259 urological medical malpractice claims closed betwe en 1995 and 1999. During this period The St. Paul Companies insured various numbers of private practice urologists. In the year's ending 1995 to 1999, 489, 492, 438, 377 and 426 individual urologists, respectively, were insur ed with respective premiums paid in the amounts of $6.27, $6.23, $5.80, $5. 15 and $3.87 million. Claims were analyzed by AUA section. The greatest inc idence of claims occurred in the Southeastern section, followed by the Nort h Central, South Central, Mid-Atlantic, New England, Western and New York s ections. According to AUA statistics the greatest number of practicing urol ogists are in the Southeastern section, followed by the Western, North Cent ral, South Central, Mid-Atlantic, New York, New England and Northeastern se ctions, When analyzing average expenses, the New England section had the mo st costly claims, followed by the Mid-Atlantic, North Central, Southeastern , South Central, Western and New York sections with respective mean expense s of $266,887, $145,031, $47,667, $41,843, $38,365, $30,037 and $1,065 per claim, respectively. The greatest percent of claims arose from the categori es of inpatient, adult and surgical procedures. Endourological procedures r esulted in the greatest incidence of surgical claims. However, claims relat ed to prostatectomy involved the most expensive claims with a mean cost of $185,345. Of the surgical procedures incidents defined as postoperative com plications were the most common acts of negligence generating a malpractice claim. The majority of malpractice claims were filed in court but subseque ntly voluntarily dismissed by the plaintiff. Conclusions: Medical malpractice persists as an issue confronting urologist s. Urologists must strive to maintain open, honest, in-depth communications with their patients when occurrences with potential malpractice overtones arise.