Medical negligence happens when a healthcare provider makes an oversight or unintentionally fails to meet the accepted standard of care, which causes harm to the patient. Even though negligence is not intentional, it can have devastating consequences for both providers and patients.
Negligence is also more common than you think: 400,000 hospital patients experience some form of preventable harm every year. Here's what medical negligence looks like and how to protect your practice.
The official medical negligence definition is any deviation from the accepted standard of care that causes harm to a patient. Medical negligence can take many forms: it's often as simple as failing to monitor a patient often enough, or failing to obtain informed consent from a patient. If a lack of action leads to patient injury or death, that's medical negligence.
If a patient experiences medical negligence, they or their family can take legal action against the medical provider(s) involved. This happens frequently, and it can be costly for the physicians involved. According to the National Practitioner Data Bank, there were 11,671 claims in 2023 that resulted in a total of $4.8 billion in settlements. The average payout in cases that were settled was approximately $420,000.
55% of medical practitioners have been sued at least once. Even if you're incredibly diligent, you could still be named in a medical negligence lawsuit, which is why it's so important to have reliable insurance coverage. Procedural specialists like surgeons and anesthesiologists are at the highest risk of lawsuits.
In order for a medical negligence suit to be successful, the patient and their legal team must prove four key legal components:
The terms "medical negligence" and "medical malpractice" are often used interchangeably. While these terms are very similar, there are some subtle differences between the two. So how does medical malpractice differ from negligence?
Negligence is the act (or lack thereof) that a healthcare provider takes that leads to patient harm. Medical malpractice is the legal claim that a patient makes after they have experienced negligence. So if a patient believes they have experienced harm as a result of medical negligence, they can file a medical malpractice lawsuit.
In a medical malpractice lawsuit or insurance policy, the two terms are often used in similar contexts and are functionally the same.
There are many different types of negligence that could lead to a medical malpractice claim if they cause patient harm. Here are five of the most common medical negligence examples.
This happens when medical providers either fail to diagnose a patient appropriately, make the diagnosis late, or make an inaccurate diagnosis. When this happens, patients often fail to get the medical treatment they need in time. This can cause symptoms to worsen and even lead to wrongful death lawsuits in rare cases.
This is the most common type of medical negligence. According to estimates from Johns Hopkins Medicine, 795,000 Americans experience harm as a result of diagnostic errors each year.
Even small errors during procedures can have serious medical consequences. One of the most common examples of surgical errors is operating on the wrong limb during surgery, which can cause extensive damages.
However, smaller procedural errors can also cause serious harm and are also considered medical negligence. For example, failing to set up a medical device correctly or entering inaccurate information in a patient's chart can cause a domino effect that makes illness or injury worse.
Many medical negligence claims also stem from medication malpractice. This happens when providers prescribe or administer the wrong medication or the wrong dose, or fail to consider potential drug interactions. This can also happen when the drug is administered via the wrong route or at the wrong time.
These errors are particularly common in inpatient settings, where busy medical teams are juggling many similar prescriptions at one time.
Getting informed consent is a must before starting any type of medical care. Informed consent ensures that patients understand the potential risks, benefits, and alternatives of the treatment they're about to receive, and gives them the autonomy to make their own decisions about their medical care.
There are many instances where a lack of informed consent can cause harm and lead to a medical malpractice case. Say a patient has a rare and serious medical condition, and the primary treatment comes with serious risks. Many patients would opt not to take this treatment due to the risk, but if they're not informed, they can't make that decision for themselves, and may experience side effects or long-term health consequences they weren't prepared for.
Birth injuries are some of the most serious and devastating forms of medical negligence. Delaying necessary care or making errors can cause injuries that affect patients and their families for life.
Medical negligence cases can be financially devastating for healthcare providers involved, and the average payout in cases that go to trial is increasing. In 2023, the average jury award among the top 50 verdicts in the US increased by 50%, hitting $48 million per case.
Not every medical negligence claim goes to trial. However, a recent trend of social inflation means that when cases do go to trial, they're more likely to result in nuclear verdicts of $10 million or higher.
Social inflation is when the average size of a jury award is rising faster than the general rate of inflation. Social inflation can also affect the cost of insurance premiums and litigation costs.
There are several causes of social inflation in medical malpractice cases. In general, juries award damages based on current and future medical expenses, lost wages, and the pain and suffering the injured party experienced as a result of the incident. However, changes in litigation tactics and social attitudes have led to an increase in higher punitive damages.
Medical negligence that results in a wrongful death suit can have particularly severe financial consequences. Medical errors are the third-leading cause of death in the United States, accounting for approximately 250,000 deaths per year. The average payout for medical negligence resulting in death typically ranges from $1 to $5 million, but can vary significantly depending on the specifics of the case.
While there are things you can do to reduce the risks of alleged medical negligence, the reality is that these claims can happen to anyone, even if you're cautious. Research indicates that physicians with one proven medical malpractice claim are four times more likely to face another in the next five years. That's why all medical professionals need a reliable malpractice insurance policy for financial protection.
Birth injuries happen in approximately 7 out of every 1,000 US births, often as the result of a medical professional's negligence. These incidents can lead to severe injuries that require lifelong patient care. Many patients and their family members file lawsuits to recover compensation for these extensive medical bills.
Because birth injuries can severely impact both the mother and child, damages can be extensive. The average birth injury settlement is over $1 million, which is roughly 30% higher than the average of all malpractice cases.
Some recent notable birth injury lawsuits include an $182.7 million verdict in Pennsylvania and an $120 million verdict in Michigan. In the Pennsylvania case, a boy developed cerebral palsy and brain damage as a result of negligence during the delivery, leading to the state's largest-ever verdict. In the Michigan case, the provider failed to perform a C-section in time, leading to brain damage.
There are several types of medical negligence that can lead to birth injuries, including:
There are approximately 67 birth injury claims for every 100,000 deliveries, making this one of the most common causes of medical malpractice claims for OB/GYNs. Cases where providers failed to diagnose or treat fetal distress also have the highest average payment amount of any malpractice category.
Because settlements in these cases are so high, OB/GYNs and other healthcare providers involved in delivery should make sure their insurance policies provide enough coverage. Ideally, policy limits should be high enough to cover a verdict of $1 million or more.
In order to win a medical malpractice case, patients and their legal teams must prove negligence happened and caused harm. Just because a patient was injured doesn't inherently mean that the medical practitioners involved were negligent.
In a medical malpractice case, the judge and jury assess whether the medical provider met the accepted standard of care for their healthcare specialty. This standard is set by the provider's medical peers.
Essentially, the defendant needs to prove that they acted how any other reasonably competent doctor would under the same circumstances. Many medical malpractice attorneys rely heavily on expert medical testimony from others in the field to establish the standard of care in these cases.
The error of judgement doctrine is a widely accepted medical defense that can protect physicians in the event of alleged negligence. Essentially, healthcare providers are allowed to exercise their judgement in good faith. When there are multiple legitimate treatment options available, physicians can make recommendations based on their professional opinion, even if others in the field disagree.
Over the past several decades, malpractice litigation has shifted significantly from active mistakes to errors of omission. Many of today's malpractice suits focus on times when the responsible party failed to act and could have prevented an adverse response.
This can be challenging for medical professionals. In busy healthcare settings, sometimes it isn't always obvious when an error of omission happens, or whether further medical intervention is required. Thorough documentation can help protect healthcare providers in this situation, as it creates a record of your reasoning and decisions in difficult situations.
Preventing medical negligence now can help you avoid costly lawsuits in the future. Here are some simple steps medical facilities can take to reduce the risk of medical negligence claims.
Medical negligence is the act of failing to meet a standard of reasonable care for patients. When this negligence leads to proven harm, the injured patient can seek compensation through the legal system with a medical malpractice lawsuit.
Medical malpractice and medical negligence are often used interchangeably in legal documents and insurance policies. Technically, medical negligence occurs when a healthcare provider fails to provide appropriate care for patients, while medical malpractice is the type of lawsuit that arises from negligence.
It depends on your situation. The statute of limitations for medical negligence varies from state to state, but is typically two to three years after the injury happened or the injury was discovered.
In some cases, the injury doesn't become apparent until many years after the negligence happened---this is particularly common with birth injuries. For physicians, the statute of limitations limits your exposure to claims and lawsuits after a set period of time.
In most cases, no. While laws vary from state to state, statutes of repose usually end around six to 10 years after the injury happened. A statute of repose starts from the time the event occurred, regardless of when the injury was discovered, unlike statutes of limitations. Because of this, all medical providers should have tail coverage on their malpractice policy for up to 10 years after their career ends.
Medical negligence claims can be devastating for your practice. Not only can they damage your reputation, but they can also lead to costly lawsuits.
That's why Indigo offers reliable medical malpractice insurance for physicians. Our policies include helpful features like free retirement tail coverage, a consent to settle clause, and options for prior acts coverage.
Our AI-powered quoting engine assesses your practice to help you get precise, tailored pricing. In the event of a claim, we partner with trusted medical malpractice lawyers in your area to help you build your defense.
Get a quote today to explore Indigo's coverage options for your practice.
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