To review currently available data on lung cancer malpractice litigation to develop litigation avoidance strategies.
A retrospective review of a publicly available database containing verdicts and settlements of malpractice cases. Data were then compared to the Physician Insurers Association of America’s (PIAA’s) Lung Cancer Study which was published in 1992. (The PIAA report is considered the best available data on malpractice and lung cancer.)
There were 89 patients in the current study and 213 patients in the PIAA study. Physicians are most often sued by patients in their 50s (mean age: 58.9 years [range 34-80 years]) current study v. 55 years (range 17-75) PIAA study) in the PIAA study. Primary care physicians (60% cases in the current study v. 33% cases in PIAA study) and radiologists (20% cases in the current study v. 55% cases in PIAA study) were named as defendants in over 75% of suits. Failure to diagnosis lung cancer was the most common reason physicians were sued (80% case in the current study v. 23.3% cases in PIAA’s series). Despite the similarity in litigation profiles, the mean award to plaintiffs, in constant dollars, increased from $172,271 in PIAA’s study to $632,261 in the current study.
(1) Recommended strategies to avoid litigation depend on physician subspecialties. While primary care physicians would benefit most from setting up a chest x-rays tracking system; radiologists would benefit most from initiating a CQI system to substantially decrease the misinterpretation rate of chest x-rays. (2) Over the past 12 years there appears to have been a substantial increase in awards to lung cancer patients who sue their physicians. However, this finding may be artificial because of differing study design. Further investigation on this subject is recommended.
Physicians are rarely sued by their patients with lung cancer after the diagnosis is made. Strategies to avoid being sued must therefore be in place prior to the time diagnosis of lung cancer is made.
T.R. McLean, None.