Nurse practitioner malpractice payouts are on the rise; opioid prescription liability an emerging hot spot

gavel and money
Neonatal malpractice claims against nurse practitioners averaged the highest paid indemnities, according to a new report. (AVNphotolab/iStock/Getty Images Plus/Getty Images)

Payouts from malpractice claims filed against nurse practitioners are on the rise, according to a new report. 

The average payouts on cases that were settled for more than $10,000 was $240,471, according to an analysis (PDF) of claims against NPs from CNA Insurance and the Nurses Service Organization, which both offer malpractice coverage. In a 2009 report, the average indemnity was $221,852 and it was $186,282 in 2012. 

Three specialties account for the highest average payouts. Neonatal malpractice claims, which accounted for just 1% of the 287 closed claims studied, averaged an $630,411 paid indemnity. Obstetrics indemnities averaged $417,500, and indemnities related to emergency care averaged $277,812. 

Neonatal and obstetrics claims in particularly were likely to lead to mid- to high-six-figure payouts, according to the report. The number of claims in emergency care also increased from 3.5% of claims in the 2012 report to 5.7% claims in 2017. 

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The report pulled the 287 closed claims from a data set of 2,236 reported adverse incidents that were settled between Jan. 1, 2012, and Dec. 31, 2016. 

Though those three specialties accounted for the costliest claims, the vast majority of closed claims studied (80.9%) were related to four other specialties: adult primary care, family practice, behavioral health and gerontology. Primary care and family medicine alone accounted for more than half (53.7%) of cases. 

Many malpractice cases in primary care or family medicine were related to a nurse practitioner's failure to order a medical test, or to obtain and address test results, according to the report.  

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The report also found that claims related to improper prescribing and management of controlled drugs, like opioids and other painkillers, has increased by about 13% since the 2012 report. The payouts for these malpractice claims can be costly, too, the report found, averaging $233,360. 

Opioids are the most common medication involved in medical liability claims, according to a separate study, involved in 24% of cases between 2012 and 2016.

Clinicians are increasingly facing significant consequences related to overprescribing; the Drug Enforcement Administration, for example, has hit some physicians with criminal charges related to overdose deaths. 

These charges are part of law enforcement's increasing focus on stopping the nationwide opioid addiction epidemic.