Malpractice Risk Impact on Obstetrics Procedures

When a patient is injured due to the medical malpractice of a physician, the injured party can sue the physician for monetary compensation under negligent tort. Compensation is typically paid for any loss of earnings capacity, pain and suffering, and reasonable medical expenses. Most physicians buy malpractice insurance to insure themselves against the payout of malpractice cases.
First of all, we need to know whether doctors have an incentive to change their behavior as a result of malpractice risk. Most physicians are fully insured against the financial costs of malpractice such as damages and legal defense expenses. In addition, medical malpractice insurance typically does not have a mechanism such as deductibles, or experience rating, either of which would give the physician a direct financial incentive to respond to increase in risk.
Litigation may, however, reduce current earnings due to the loss of practice time, or future earnings due to the loss of reputation. Additionally, there may be substantial legal expenses and emotional stress associated with a lawsuit. Therefore, doctors have two strong incentives: not to be involved in malpractice litigations even with malpractice insurance due to the hassle of involvement and not to pay large payout in the lawsuit since his/her reputation might depend on the size of the payout.
The birth of a neurologically-impaired infant is the most prevalent reason for a lawsuit in the OB/GYN specialty. Impairment can occur before or during deliveries as a result of fetal distress by a constricted umbilical cord, hemorrhage behind the placenta or intrauterine infection after prolonged rupture of the membranes. In deliveries involving a birth injury, doctors are more likely to be suspected as negligent when the baby is delivered vaginally due to the limited control of progress compared to cesarean section.
To understand current defensive medicine during hospital birth requires, first and foremost, understanding the process whereby physicians have come to act as what is here termed – fetal champions . Therefore, defensive medicine is centered on concerns regarding the condition of the fetus. In case of vaginal delivery, the doctor should prove that cesarean section would not have made any difference and should convince people that everything has been done. It know well known that many OB/GYNs follow a – When in doubt, cut it out – philosophy which encourages C-sections whenever the doctor has any concerns that a vaginal delivery may threaten the health of an infant.
The ‘failure to deliver by C-section’ complaint is frequently listed as a reason for a malpractice claim. In a retrospective review of physician malpractice claim records in
malpractice insurer, underperformance of cesarean section was cited 10 times more often as a reason for a malpractice suit than failure to deliver the baby vaginally, 31 % vs 3%, respectively.
The active role of the physician during C-sections may also help reduce the probability of litigation conditional on a poor outcome. For example, a doctor does not want to be exposed to a situation in which he/she is absent from the hospital during the patient’s labor. Vaginal delivery will increase the chance of this occurring due to longer labor times. Compared to a vaginal delivery, doctors play a more active role in deliveries by cesarean section.
During the past year, it has been called for medical liability reform to protect patients, to stop sky-rocketing costs associated with frivolous lawsuits, to make health care more affordable and accessible for all patients, and to keep necessary services in communities that need them most. A frequent justification for tort reform is the concern that malpractice risk may encourage doctors to alter their practice style. To date, there is little evidence supporting this point.
It have been found increased malpractice risk has little if any impact on health care access, as measured by the number of prenatal doctor’s office reports. It has been found that no statistically significant change in other measures of treatment such as ultrasound, forceps, and vacuum as malpractice risk changes. Even though it has been found that some significant increase in the use of amniocentesis when malpractice risk increases, but overall there are no substantial changes in behavior by obstetricians as malpractice risk increases.

Attorney / Mohamed Al Marzooqi
Mohamed Al Marzooqi advocates & Consultancy
Lawyer in Abu Dhabi, Dubai – UAE

Malpractice Risk Impact on Obstetrics Procedures When a patient is injured due to the medical malpractice of a physician, the injured party can sue the physician for monetary compensation under negligent tort. WhatsApp: +971555570005