Most common medical liability claims and costs: Pediatrics

A specialty snapshot provided by the Medical Professional Liability Association (MPL Association) Data Sharing Project reports pediatrics as not being in the top ten specialties with reported claims between 2017 and 2019. Pediatrics is in nineteenth place in their ranking. 

Between 2017 and 2019, there were 339 pediatric closed claims and lawsuits reported, constituting 1.6 percent of all closed claim data. Of these claims and lawsuits, 108 resulted in indemnity payments totaling more than $60 million.

(graphic - Top allegations for pediatrics (2017-2019))

Diagnostic errors made up 53 percent of allegations and 28 percent of allegations were related to procedures. Patient death occurred in 7 percent of incidents reported, with cardiac arrest being the most prevalent and expensive outcome.

Additional Insights

Top presenting medical conditions by closed claims:

• General examination 
• Nausea and vomiting
• Disorders of newborn related to low birth weight and short gestation, not elsewhere classified
• Live-born infants according to place of birth and type of delivery
• Respiratory distress of newborn

Top procedures:

• Diagnostic procedures
• No care rendered
• Other diagnostic procedures on skin subcutaneous tissue fascia and breast 
• Prescription of medication 
• Respiratory intubation and mechanical ventilation

Top outcomes:

- Cardiac arrest

- Emotional distress

- Other brain disorders

- Intracranial laceration and hemorrhage due to birth injury

- Foreign body in alimentary tract

Defense costs

Most pediatric claims (61 percent) were shown to lack merit, resulting in dropped, withdrawn, or dismissed cases with no indemnity payment to the claimant. The average defense cost for these non-meritorious claims was $40,283.

(graphic: Percentage of closed claims by resolution)

Of the closed claims, 32 percent resulted in an average indemnity payment of $559,603, higher than all health care specialties combined ($368,035).

(graphic: piggy bank)

The average indemnity payment for pediatric claims was $559,603 but claims involving grave injuries had the highest average indemnity payment of $1,100,00. The largest payments reported for a pediatrics claim was $2 million.

Six percent of claims were resolved through trial verdict, and the jury found in favor of the defendant 90 percent of the time. The average cost to defend these claims was $237,702.

About the MPL Association

The MPL Association is the insurance industry trade association that represents a full range of entities doing business in the medical professional liability arena. These include domestic and international MPL insurance companies, risk retention groups, captives, trusts, and other entities. MPL Association members insure nearly 2.5 million healthcare professionals around the world. MPL Association members also insure 2,700 hospitals and 15,000 medical facilities and group practices globally.

Participating MPL Association member companies submit MPL claim data to the Data Sharing Project in a codified format. The Association provides explicit definitions and requirements for each data field captured. Data is collected in a generic format—the identities of individual claimants, insureds, and other parties are not captured. Exposure data is not collected in the DSP; therefore, the frequency of claims per physician cannot be measured.

This information is intended to complement other data currently in use to identify claim trends and payment patterns. Data quantifies the proportion of closed claims resulting in indemnity payments (specifying average, median, and largest payment amounts) and defense expenses. 

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