Abstract
Purpose:
Previous studies suggest that fear of litigation may influence medical decision-making by some physicians. One factor that may influence a physician is the litigious tendency in the region of practice, while the other may be the specialty of medicine. Vitreoretinal specialists and diseases related to retina may be especially susceptible to litigation as retinal conditions tend to be emergent and many may result in severe and permanent vision loss. We reviewed malpractice claims associated with diseases and surgeries related to the retina and compared the medicolegal outcomes among the various states of the insured retina specialists.
Methods:
Closed claims data from an ophthalmic insurance company that has insured in all states except Wisconsin for a 10-year period between 2003 and 2012 were reviewed. Claims filed against retina specialists were identified and outcomes were analyzed and compared based on the individual states of the retina specialists.
Results:
During the 10-year period, there were 2,246 closed claims and 344 (15.3%) were related to retina related claims (RRC). Of the 344 RRC, 42 (12.2%) resulted in indemnity payments totaling $11,587,732 (mean = $275,898, median = $150,000). RRC arose in 36 of 49 states. The top 5 states with the most RRC were California (72), Florida (40), Texas (36), Michigan (27), and Louisiana (20) and accounted for 57% of all RRC. There were a total of 5,426 insured years of retina specialists (RSIY). Top 5 states with the most number of RSIY were Florida (542), California (523), Texas (437), Illinois (390), and Virginia (382). Relative risk for claims was estimated by dividing the number of RRC by RSIY for each state. The top 5 states with the highest risk for claims were Mississippi (0.500), Kansas (0.400), Rhode Island (0.300), Indiana (0.25), and Idaho (0.192).
Conclusions:
States with the most number of RRC tended to have the highest number of insured years by retina specialists and 5 states accounted for the majority of RRC. However, when relative risk for claims was assessed, the top 5 states were not the states with highest number of RRC, but rather from states with few claims resulting from few retina specialists. However, most claims did not result in indemnity payments.