Educational Objective: At the conclusion of this presentation, the participants should be able to define captive insurance, understand the components of a lawsuit, and recognize trends in otolaryngology malpractice claims.
Objectives: To report key characteristics and patterns of captive insurance claims not publicly reported in otolaryngology across a large tertiary level academic health system over the previous two decades.
Study Design: Retrospective review.
Methods: The internal captive insurance database at a tertiary level healthcare system was queried to identify otolaryngology related malpractice claims regardless of final disposition (settled or dismissed) filed from 2000 to 2020. Date of incident, date of claim, patient age, error type, patient outcome, provider subspecialty, number of defendants, type of defendant, total expenses, disposition, and final reward amount were recorded.
Results: Twenty-six claims were identified. Head and neck surgery was the most frequently implicated subspecialty (34.6% of all cases), followed by general otolaryngology (26.9%), skull base/rhinology (19.2%), pediatrics (15.4%), and resident trainee (3.8%). Improper surgical management was cited in 9/24 cases (34.6%), followed by failure to diagnose (26.9%), treat (15.4%), and obtain informed consent (11.5%). A total of 6 (23%) cases had a deceased outcome with 20 (76.9%) alive. A total of 16 (59%) cases settled and 9 (33%) dismissed all parties. Only 3 cases settled on behalf of the individual otolaryngologist whereas the rest on behalf of the hospital. For deceased outcomes, median reward was $500,000, whereas, for alive outcomes, the median reward was $105,000 (p=0.019).
Conclusions: This study uniquely analyzes malpractice claims not captured by publicly documented legal dockets or national disclosures. Reward amount was significantly higher in outcomes involving deceased plaintiffs. This data encourages otolaryngologists to better gauge current quality and safety measures that best protect patients from harm.