PC1254: Medical Malpractice Lawsuits Involving Pediatric Trainees

Purpose/Objectives: Medical malpractice litigation against pediatric trainees is rarely discussed. Although rare, pediatric trainees can still be held accountable and subsequently be included in malpractice suits. Our objective was to understand the source of pediatric malpractice cases to be able to coach trainees during their practice to best protect themselves.

Design/Methods: LexisNexis, an online public legal research database containing records from the United States, was retrospectively reviewed for malpractice cases involving pediatric interns, residents, or fellows from January 1, 2000, to December 31, 2021. Cases were included if malpractice occurred following delivery of a newborn through the care of young adults up to age 21. Cases involving prenatal care or care provided during delivery were excluded for significant overlap with trainees within other medical fields.

Results: A total of 56 cases were included consisting of 10 pediatric interns, 43 second or third-year residents, and 11 pediatric fellows as defendants. A total of 9 cases involving surgical procedures performed by pediatric surgical residents or fellows were included. A total of 17 cases (30.4%) led to patient mortality. Incorrect diagnosis or treatment was claimed in 45 cases (80.3%), delay in evaluation in 24 (42.9%), failure to supervise trainee in 22 (39.3%), trainee inexperience in 21 (37.5%), procedural error in 21, lack of informed consent of resident being involved in 2 (3.6%), prolonged operative time in 1 (1.8%), and lack of informed consent of procedure/complications in 1. Of the 56 cases, 28 (50.0%) resulted in settlement, 11 (19.6%) resulted in verdicts favoring the plaintiff, and 17 (30.4%) cases resulted in verdicts for the defense. The average time from medical injury to verdict date was 6.2 years. The median time to verdict for the defense was 6.3 years (IQR 4.6-7.9 years), for the prosecution 6.8 years (IQR 5.4-10.3 years), and for settlements 4.8 years (IQR 3.4-6.0 years). The damages claimed in settlements averaged $6,090,024 (median $2,000,000; IQR $1,562,500 - $4,900,000) and in plaintiff verdicts averaged $7,965,760 (median $4,620,000; IQR $975,000 - $10,100,000).

Conclusion/Discussion: Malpractice cases involving pediatric trainees highlight the importance of adequate supervision by attending physicians. These concerns are not exclusive to interns and residents and necessitate action by all members on healthcare team. Given the interplay of supervision and diagnostic accuracy, trainee education and faculty development should emphasize malpractice education and strategies to mitigate lawsuits to both improve patient outcomes and reduce likelihood of future malpractice claims.