Professional liability of residents in a children's hospital
J. Grupp-Phelan, S. Reynolds and L. L. Lingl
Department of Pediatrics, Children's Memorial Hospital, Chicago, Ill., USA.
OBJECTIVE: To evaluate the risk of professional liability to house staff
within a pediatric hospital setting. METHODS: A retrospective study
describing the patients, allegations, areas within the hospital where
complaints originated, and outcome of all malpractice suits involving
residents from 1968 through 1992 at a large pediatric teaching hospital.
RESULTS: There were 49 malpractice cases involving residents with or
without physicians from 886,000 hospital admissions or emergency department
visits over the past 20 years (5/5/100,000 patient encounters) compared
with 185 malpractice cases involving attending physicians alone at the
hospital (20.5/100,000 patient encounters). The incidence of cases
originating from the emergency department was 1.8/100,000 compared with
13.9/100,000 from all other areas of the hospital combined. Fifty-two
percent of patients had preexisting chronic medical problems. Forty-nine
percent of cases were settled out of court, 2% went to trial with a
decision in favor of the plaintiff, 22% were dismissed, and 27% of cases
remained open as of June 1993. The mean award on behalf of patients from
1968 through 1979 was $580,000 per case with a median payment of $163,000.
The mean award from 1980 through 1992 was $760,000 per case with a median
payment of $275,000. CONCLUSIONS: Malpractice risk is serious concern for
residents and a financial liability for hospitals. Resident physicians in a
pediatric teaching hospital were named in 26% of malpractice cases. Most
cases were settled or were dismissed and did not go to trial. Risk
management training during residency may reduce resident involvement, and
by extension, the teaching institution's involvement in malpractice
litigation.
