Report: 80% of obstetrics liability claims involve high-severity injuries 

Pregnant woman getting checkup
Obstetrics liability claims often include injuries with high clinical severity. (Getty/byryo)

Obstetrics represents a sliver of liability claims, but a new report suggests that many of these cases involve patient injuries of greater severity.

Coverys, a Boston-based liability insurer, analyzed 472 obstetrics claims from between 2013 and 2017 and found that 80% were high clinical severity cases. In 24%, either the mother, infant or both died. 

Complications or injuries to mothers are less common than injuries to babies. Infant claims tended to fall in one of three categories: neurological or brain damage (41% of cases), shoulder injuries (37%) and death or stillbirth (34%), according to Coverys’ research. 


2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

“These claims are really severe and really expensive,” Marlene Icenhower, senior risk consultant at Coverys and the report’s author, told FierceHealthcare. 

RELATED: Report identifies area for improvement in the diagnostic process to prevent medical errors  

These injuries also often cause long-lasting effects, so the upfront claims are high and the patients—particularly in the case of infants—often need costly chronic care in the long term, according to the report. 

The report also identifies risk areas that providers can focus on to improve outcomes for obstetric care. Pregnancy, labor and delivery are especially rife with miscommunication opportunities, according to Coverys, since many expectations about the experience are baked in. 

Pregnant women often have images in mind of what their birth experience will be like that aren’t rooted in evidenced-based care but instead in folklore, culture, blogs and conversations with their peers, Icenhower said. Obstetricians need to address these expectations long before delivery, she said. 

“Physicians have to anticipate and prepare for that,” she said. “Begin early, and have a good, communicative relationship with your patient. Discuss some of the things that can happen, and sort of work through the expectations in the context of a realistic birth plan.” 

Midwives pose another communication risk, according to the report. For one, state-level regulations on licensing vary, so some may have a far lower level of clinical experience. That’s why it’s crucial for obstetrics departments to have clear agreements in place that outline responsibilities and emergency protocols. 

RELATED: A ‘dangerous duo’—Opioids, anticoagulants involved in 40% of medication-related liability claims 

Nearly half (40%) of obstetrics claims relate to management of labor and delivery, according to the report. More claims were tied to vaginal births than cesarean sections, and a vaginal birth following a previous C-section is especially risky, Icenhower said. 

These procedures are especially linked to risk of obstetric hemorrhage, one of the major causes of death in childbirth, she said. So hospitals need to be prepared for these situations—including abandoning a vaginal birth if necessary—and should drill regularly to keep clinicians’ skills in top shape. 

Another key risk factor during labor is poor monitoring of fetal heart patterns, Icenhower said, so that too should be a part of routine training and skill checks. 

“We recommend that folks be trained consistently on fetal heart patterns when they first get hired at the hospital,” she said.

Suggested Articles

Two lawsuits were filed suing the Trump administration to overturn a new rule that would allow healthcare workers to deny care over religious or conscience…

Policy changes are affecting how investors view the skilled home health market and paving the way for potential strategic acquisitions.

JLABS executive Kate Merton talks about the JLABS model and Johnson & Johnson’s interest in digital health.