Study Analyzes Litigation Related to Cardiac Catheterization

September 9, 2013—Candice Kim, MD, and Mladen I. Vidovich, MD, conducted an investigation of medicolegal characteristics of cardiac catheterization litigation in the United States from 1985 to 2009. The study has been published online ahead of print in the American Journal of Cardiology (Am J Cardiol).

The investigators noted that there are few assessments of patterns of medicolegal cases involving cardiac catheterizations.

As summarized in Am J Cardiol, this descriptive study reviews the patterns of liability and medical outcomes involving cardiac catheterization litigation from the LexisNexis Academic database and the Physician Insurers Association of America registry.

The investigators reported that from 1985 to 2009, the Physician Insurers Association of America registry documented 1,361 closed coronary angiography claims, of which the cardiovascular disease specialty was involved in 699, with other specialties involved in the remaining cases.

Of the 1,361 closed claims, 301 (22%) resulted in payments to the plaintiff (average indemnity, $230,987). The most common alleged error was for improper performance (35.4%; average indemnity, $255,542). The alleged error with the highest average indemnity of $270,916 was errors in diagnosis. Not performing an indicated procedure had the highest ratio of paid to closed claims (41%), with an average indemnity of $246,988. In regard to the severity of injury, death was the most common outcome (44%). The highest ratio of paid to total closed claims (43%) was for grave injuries (highest average indemnity, $555,625).

Of the 116 LexisNexis cases, litigation against physicians occurred in 90.5% of cases, with judgments in favor of the patients in 29.5%. When death was the outcome (31% of cases), physicians were highly likely to be sued (97%), and the judgment was more likely in the plaintiffs' favor (44%).

This evaluation found that in litigation related to cardiac catheterizations, most cases are due to medical malpractice, and physicians are sued in a high percentage of cases. Cardiologists should recognize these patterns of litigation, as these may impact and improve processes of care, concluded the investigators in Am J Cardiol.