Most common medical liability claims and costs: Orthopedic surgery

November 16, 2020 Sara Bergmanson

A specialty snapshot provided by the Medical Professional Liability Association (MPL Association) Data Sharing Project reports orthopedic surgery as being among specialties with the highest number of medical liability claims between 2016 and 2018.

Top 10 specialties by closed claims

The 1,328 orthopedic surgery closed claims and lawsuits make up 7% of all closed claim data within those two years. Procedure incidents make up 76% of allegations and 14% of allegations are related to diagnostic issues.

Complications of internal and orthopedic prosthetic devices, implants, and grafts were the most prevalent and expensive outcome for orthopedic surgery claims. Patient death accounted in 8% of all incidents reported.

Additional insights

Top presenting medical conditions:

  • Osteoarthritis of knee
  • Osteoarthritis of hip
  • Other joint disorder, not elsewhere classified
  • Fracture of lower leg, including ankle
  • Thoracic, thoracolumbar, and lumbosacral intervertebral disc orders

Top outcomes:

  • Complications of internal orthopedic prosthetic, devices, implants and grafts
  • Complications of procedures, not elsewhere classified
  • Other acquired deformities of limbs
  • Other joint disorder, not elsewhere classified
  • Intraoperative postprocedural complications and disorders of nervous system, not elsewhere classified

Top procedures:

  • Arthroplasty knee
  • Hip replacement; total and partial
  • Spinal fusion
  • Other OR therapeutic procedures on joints
  • Other diagnostic procedures

Defense costs

63% of the orthopedic surgery claims were non-meritorious resulting in dropped, withdrawn, or dismissed cases with no indemnity payment made to the claimant. The average defense cost for these non-meritorious claims was $31,125.

Top allegations among orthopedic surgery claims

30% of orthopedic surgery closed claims resulted in an average indemnity payment of $346,336, which is below the average of all health care specialties combined ($371,560).

Orthopedic surgery total and average indemnity

32% of orthopedic surgery claims involving a patient death had an average indemnity payment of $618,909.

34% of the closed claims involving complications of internal orthopedic prosthetic devices, implants, and grafts resulted in an average indemnity payment of $213,092.

6% of claims were resolved through trial, and the average cost to defend these claims was $164,927. The jury found the orthopedic surgeon in favor 92% of the time.

Major permanent injuries had the highest average indemnity payment at $747,199. The largest payment reported was $3 million.

Top 10 specialties by paid claims

About the MPL Association

The MPL Association is the insurance industry trade association that represents a full range of entities doing business in the medical professional liability arena. Their mission is to promote, protect, educate, and connect medical professional liability insurers that support the quality delivery of healthcare and practice of medicine. MPL Association members insure nearly 2 million healthcare professionals around the world including more than two-thirds of America’s private practicing physicians.

The MPL Association launched the Data Sharing Project in 1985 to identify areas in the practice of medicine that are most vulnerable to medical liability claims as well as support efforts towards medical liability reform. It is the largest ongoing independent collaborative database of medical professional liability claims and lawsuits.

Reprinted with permission from the MPL Association. DSP Specialty Snapshot, 2020 Edition. MPL Association. Copyright, 2020.

The information provided may be used for personal use only. Any other use requires prior permission of the MPL Association.

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