| Case Examples: A 70-year-old male underwent an elective hernia procedure. During the procedure, a bottle nick was found, which required additional surgical intervention. Post-surgery, the patient incurred lost wages and additional medical costs. Can this patient be assisted and avoid potential litigation? A 43-year-old female patient developed complications after a laparoscopic procedure and required a return to the operating room for the repair of bowel and bladder injuries. Incurring additional time away from work, lost wages, and additional healing time. The complications were a potential risk of the procedure; however, the patient’s perception was that this was not routine and that something must have gone wrong. Can this patient be assisted, and potential litigation avoided? A 33-year-old female sustained a cervical laceration and ureteral injury during an urgent cesarean section, and required surgical repair, and stent placement, along with subsequent procedures for removal. She requested assistance with lost wages. Can this patient be assisted, and potential litigation avoided? See the end of this article for the “rest of the story” on these adverse patient events. |
Importance of Early Reporting of Adverse Events or Potential Claims
As a provider, we know that you care about your patients and their outcomes. At MPIE, we understand that adverse events, unexpected outcomes, known risks, and patients who are dissatisfied or threatening a legal proceeding will occur. According to the Medscape Malpractice Report (2021), “more than half of physicians will be named in a lawsuit at some point in their career—whether or not they’ve made a medical error.” Deciding to report an adverse outcome or patient issue is always challenging. However, early reporting of these adverse events or legal threats is critical, as reporting has been statistically proven to result in decreased legal costs, time to resolution, and may avoid a lawsuit.
Benefits of Early Reporting
- Helps preserve the Physician-Patient relationship by implementing:
- Transparency – Assistance for providers with disclosure of adverse events to patients/family as appropriate.
- Assistance – If appropriate, utilize MPIE’s Giving Assistance to Patients and Providers (GAPP) Program.
- Assists the healthcare provider
- Stress – Engaging MPIE’s Physician Resilience Program, Litigation Stress Support Program, or Peer-to-Peer Support Program assists the provider with stress management.
- Engagement – Enabling MPIE Claims Management Team to review the event and work with the provider in resolving and mitigating financial risk.
- Ensures compliance with insurance reporting requirements under your policy
- Enables MPIE to assist in preserving information for the future defense of a claim or State Investigation.
- Enables MPIE, with the consent of the insured provider, to engage with a patient or family representative to resolve a claim early, confidentially, and without the need for protracted litigation.
Early reporting may help to preserve the provider-patient relationship through transparency and assistance. Additionally, using early reporting, restoration and healing between the patient and provider may occur more quickly versus waiting for a formal claim to be lodged and the relationship is irreparably damaged. MPIE has programs available to support the healthcare provider, preserve useful information in defending a claim, or if necessary, resolve a claim quickly and efficiently without the need for expensive and time-consuming litigation. Early reporting is key, allowing MPIE to evaluate a claim and determine liability and exposure and obtain the best possible outcome when presented with a potential medical malpractice claim.
Cases in Follow Up
Each one of the case example patients qualified for and was assisted through MPIE’s Giving Assistance to Patients and Providers (GAPP) Program. Every patient was assisted according to their needs, and all were satisfied with the assistance given. None of the case examples have proceeded to litigation. As a provider, report early, as it may help with the provider-patient relationship, may help make your patient “whole”-through physical healing, and financial assistance, and may prevent litigation after an adverse event.
Reporting requirements may vary based on the circumstances of a reported event and your specific policy coverage. If you have questions about whether an event requires reporting, MPIE can assist in determining the appropriate course of action.
Additional Resources
- Reporting a claim or event to MPIE – https://www.mpie.org/claims/
- MPIE’s Physician Resilience Program – https://www.mpie.org/claims/resilience/
- Disclosure Support – Communication and Optimal Resolution (“CANDOR”) – https://www.ahrq.gov/patient-safety/settings/hospital/candor/index.html
- The Earlier the Better: More Med Mal Insurers Offer Real-Time Support After Patient Harm – https://www.rmf.harvard.edu/clinician-resources/podcast/2021/early-resolution
- Manage Stress and Maintain Health during the Legal Process – https://vimeo.com/695819548/9711db6732
If you are an employed provider of a healthcare system and have questions on this subject, please consult your organization’s risk management department for advisement as to system policy or protocol.