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The objective of this study was to explore associations between allegations of malpractice and the severity of the alleged malpractice injury. The public-use data file of the National Practitioner Data Bank was used to identify 34,042 dentist malpractice reports from January 1, 2010, through December 31, 2020. Univariate descriptive analysis was conducted to identify frequencies of malpractice allegations when classified by the severity of the alleged malpractice injury, practitioner graduation year, and year of original report processing. Ordinal logistic regression analyses were conducted to explore associations between the malpractice allegation type and the severity of the alleged malpractice injury. A total of 15,183 valid reports were used in the analysis. Compared with treatment-related allegations, a surgery-related allegation proved 5.3 times more likely to result in minor permanent injury; a diagnosis-related allegation was 6.5 times more likely to result in significant permanent injury and 10.4 times more likely to result in major permanent injury; and an anesthesia-related allegation was 6.2 times more likely to result in major permanent injury. The confounding variable of graduation year proved significant with respect to major temporary and minor permanent injury. As the allegation group advanced from diagnosis-related to anesthesia-, treatment-, and surgery-related allegations, the odds of a higher severity of injury did not increase. Establishing a proper diagnosis and developing a treatment plan to manage the anticipated complications of the procedure to be performed are critical to a successful outcome. [ABSTRACT FROM AUTHOR]

The article discusses data and data analysis in relation to incidents of medical malpractice in America, and it mentions the U.S. National Practitioner Data Bank repository which contains information about physicians' closed medical malpractice claims and adverse actions involving doctors. The malpractice-related actions of physicians such as Drs. Najam Azmat, Christopher Duntsch, and Jacques Roy are assessed.

The article discusses in the context of insurer-physician relations, the National Practitioner Data Bank (NPDB) which was created by the U.S. Congress in 1986 to address the increase in medical liability cases. Topics covered include the potential distortive effect of NPDB on litigation and settlement, the attempts to alter reports that triggered litigation against reporting entities and the NPDB, and the problems that the NPDB have caused physicians.

Today's healthcare system is in a state of transformation, as changes in technology, diagnostic approaches, treatments, and levels of professional practice occur on a regular basis. Nurses continue to be the most trusted profession. What has not changed in clinical practice is the amount of responsibility and level of accountability. Therefore, nurses are morally, legally, and ethically responsible for nursing judgment and clinical-based actions covered under each state's Nurse Practice Act, the American Nurses Association's core principles, and position statements as well as standard setting documents from professional organizations. Unfortunately, mistakes happen in an enormous system where human error cannot be entirely avoided, which is why being named in a board of nursing complaint can be so devastating. Stress and accusations of not providing reasonable or prudent care can be overwhelming, which may impact a perinatal clinician's health. This article's purpose is to provide information about the process of a board of nursing complaint, potential sequelae of an investigation, as well as best practices to decrease risk, focusing exclusively on perinatal nurses and advanced practice providers. [ABSTRACT FROM AUTHOR]

State medical boards are increasingly responsible for regulating medical and osteopathic licensure and professional conduct in the United States. Yet, there is great variation in the extent to which such boards take disciplinary action against physicians, indicating that some boards are more zealous regulators than others. We look to the political roots of such variation and seek to answer a simple, yet important, question: are nominally apolitical state medical boards responsive to political preferences? To address this question, we use panel data on disciplinary actions across sixty-four state medical boards from 1993 through 2006 and control for over-time changes in board characteristics (e.g., composition, independence, budgetary status), regulatory structure, and resources. We show that as state legislatures become more liberal [conservative], state boards increasingly [decreasingly] discipline physicians, especially during unified government and in the presence of highly professional legislatures. Our conclusions join others in emphasizing the importance of state medical boards and the contingent nature of political control of state regulation. In addition, we emphasize the roles that oversight capacity and strategy play in offsetting concerns regarding self-regulation of a powerful organized interest. [ABSTRACT FROM AUTHOR]

Background: Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups’ distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards. Methods and Results: We conducted a cross-sectional analysis of physician reports submitted to the National Practitioner Data Bank (NPDB) from January 1, 2003, through September 30, 2013. A total of 1039 physicians had ≥ 1 sexual-misconduct–related reports. The majority (75.6%) had only licensure reports, and 90.1% were 40 or older. For victims in malpractice-payment reports, 87.4% were female, and “emotional injury only” was the predominant type of injury. We found a higher percentage of serious licensure actions and clinical-privileges revocations in sexual-misconduct–related reports than in reports for other offenses (89.0% vs 68.1%, P = < .001, and 29.3% vs 18.8%, P = .002, respectively). Seventy percent of the physicians with a clinical-privileges or malpractice-payment report due to sexual misconduct were not disciplined by medical boards for this problem. Conclusions: A small number of physicians were reported to the NPDB because of sexual misconduct. It is concerning that a majority of the physicians with a clinical-privileges action or malpractice-payment report due to sexual misconduct were not disciplined by medical boards for this unethical behavior. [ABSTRACT FROM AUTHOR]

In an effort to meet the challenges of the post-health reform marketplace, hospitals have accelerated the practice of employing physicians. Despite this trend, many hospitals require their employed physicians to also maintain membership and privileges on the medical staff--the self-governing entity comprised of fellow physicians that oversees the practice of medicine within the hospital setting. Recent case law identifies at least two salient issues that will likely arise from physicians' dual roles as hospital employee and medical staff member and be a point of negotiation and litigation: (1) the applicability of "due process" rights, which are typically afforded in medical staff peer review actions, to employment termination actions, and (2) the obligation to report employment termination actions to the federal government's National Practitioner Data Bank, a central database for information about medical staff peer review actions and other incidents that may reflect on physicians' competence and quality of care. This article examines how and why these issues may become points of contention and proposes various practical solutions to avoiding or mitigating such conflicts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Our objective is to compare legal difficulties that psychiatrists encounter in regulatory agency and malpractice (insurance) settings. METHODS: Data sources included a literature search of malpractice and medical board discipline from 1990 to 2009 (rates and types of discipline); publicly available insurance data (malpractice frequency and type); and data from the National Practitioner Data Bank (NPDB) (required reports of malpractice settlements and hospital discipline). RESULTS: Medical board discipline findings indicate that psychiatrists are at increased risk of disciplinary action compared with other specialties. NPDB data indicated relatively infrequent problems for psychiatrists. In malpractice, psychiatry accounted for a small percentage of overall claims and settlements. Overall, more years in practice and a lack of board certification increased the risk of legal difficulties. CONCLUSIONS: There are shared and separate risk factors in the malpractice and regulatory agency areas, but there is evidence that these 2 legal areas are distinct from each other. [ABSTRACT FROM AUTHOR]

In 1990, the federal government created a clearinghouse to track, among other things, all medical malpractice payments made in the United States. Congress created the National Practitioner Data Bank (NPDB) as a repository to hold information about individual doctors' malpractice and disciplinary histories. Doctors' NPDB files, while not visible to the public, are available to medical organizations. The availability of doctors' NPDB files aid medical organizations in making better hiring decisions, as well as preventing incompetent doctors from moving from state to state in the hope of escaping local regulators. The NPDB's existence, though, has become a significant barrier to malpractice claims settlement. Many doctors fear being listed in the NPDB and this has significantly diminished the likelihood of payment when a claim is made (a claim made post-NPDB is only 59% as likely to attract a settlement as a pre-NPDB claim). Fear of being listed in the NPDB has resulted in a culture of evasion and exploitation of reporting loopholes that weaken the NPDB's data collection efforts. This Article argues that, while the NPDB seeks to protect potential malpractice victims from inept doctors, part of the cost has been borne by actual malpractice victims. These patients are now more likely to go without compensation because payments would create a paper trail of past performance that some doctors are unwilling to allow to exist. This article tells the story of the NPDB -- and organized medicine's response to it -- and argues for improvements to remove barriers to fair compensation and to improve the NPDB's ability to track malpractice data. [ABSTRACT FROM AUTHOR]

As a nationwide flagging system, the National Practitioner Data Bank (NPDB) allows state licensing boards, hospitals, and other registered healthcare entities the ability to monitor practitioners through reporting and inquiry about the qualifications and competency of healthcare practitioners seeking clinical privileges where incompetence or unprofessional conduct could adversely affect a patient's welfare. Certified Registered Nurse Anesthetists are not exempt from being reported on or queried by registered reporting and querying entities. The NPDB warehouses data pertaining to adverse actions or medical malpractice payments taken against a Practitioner. Based on the undated federal ruling published in the Federal Register regarding the NPDB and Section 1921 of the Social Security Act, the NPDB has expanded the definition of healthcare practitioners to include all healthcare practitioners as a means of protecting beneficiaries of the Social Security Act's healthcare programs. As such, nurse anesthetists should be aware of the additional reportable information that may be collected or disseminated based on the updated ruling pertaining to the NPDB. [ABSTRACT FROM AUTHOR]

The article compares the physician blacklisting with other forms of blacklisting in order to highlight the problems with the National Practitioner Data Bank (NPDB). It informs that the number of government-created blacklists is growing for the U.S. in areas such as convicted sexual predators, suspected gang members, and suspected terrorists. It also informs that the NPDB problems can be resolved by providing similar due process protections to physicians that are provided to sexual offenders.

Accessible summary Clinical supervision (CS) is a valuable resource for mental health nurses. Through guided reflection and supportive facilitation, the recipient of CS works towards developing their therapeutic practice., In many parts of the UK, the implementation of CS does not equate to best practice. This provision undermines and thwarts the potential gains that effective CS can produce., The development of a database of clinical supervisors may ensure that best practice guidelines are implemented., Information about a database that focuses on clinical supervisors of psychological therapies, including its rational, clarifying the intention of CS, and criteria of supervisors, are described., Abstract Clinical supervision (CS) is regarded as a valuable resource for mental health nursing. While there is considerable anecdotal reports of its implementation throughout the UK, these attempts are not without difficulty. A common tension reported in the literature relates to its provision being more akin to managerial supervision within a line-management hierarchy which jars with its original intention and spirit. This paper will provide a discussion on the implementation of CS in mental health nursing in the UK, beginning with its suggested importance for the discipline. Following on from this, the rationale for a CS database and description of one NHS Board's attempts at developing a resource, initially focusing on clinical supervisors of psychological therapies, will be presented. [ABSTRACT FROM AUTHOR]

Health care has witnessed c. rapid growth in the use of alternative dispute resolution. Nationwide, many hospitals are adopting early dispute resolution programs in which, when they err, they approach injured patients with disclosure, apology, and restitution. The results have generally been outstanding—better serving patients and families' needs, and better for institutions as they save large sums on defense costs while improving safety and quality of care. Unfortunately, physicians are largely left standing on the sidelines. Medical malpractice payments, no matter how small, and no matter why they were made, must generally be reported to the National Practitioner Data Bank, where they remain as a black mark for the rest of the physician's professional life. Weighing the high odds of winning if they defend in litigation, versus a guaranteed black mark if they settle early, physicians are not often interested in early mediation. The literature is remarkably silent about this enormous disconnect. This article attempts to fill that void, exploring why physicians commonly abjure early mediation and recommending several specific, lawful ways for them to avoid the data bank and thereby embrace early dispute resolution. In the process, the article addresses the "moral hazard' issues attendant to dodging the data bank, so that ultimately physicians should be able to take a more active role in early mediation of medical malpractice disputes. [ABSTRACT FROM AUTHOR]

An essay is presented on medical malpractice and the need of improvement in the medical care quality of the U.S. It discusses the need of Health Care Quality Improvement Act (HCQIA) and National Practitioner Data Bank for information about physicians. It further discusses the listing of hospitals with high mortality rates by the U.S. Department of Health and Human Services and the public releasing of quality information and health care provider cost.

The article discusses a study which investigated paid malpractice claims for adverse events in both outpatient and inpatient settings in the U.S. from 2005 through 2009. Data from the National Practitioner Data Bank (NPDB), a repository of all malpractice claims in the U.S., were analyzed. Parameters evaluated include number of paid claims, types of errors, payment amounts, and outcomes of errors. The study concluded that the number of paid malpractice claims in 2009 for events in the outpatient setting was similar to the number of claims in the inpatient setting.

The United States Congress mandated the establishment of the National Practitioner Data Bank in large part to decrease the likelihood that errant individuals might be able to avoid detection by licensing boards and practice medicine. We use a decade of longitudinal data (1985-94), for each of the 50 states, to evaluate the Bank's impact on state licensing board actions, during the four years following its 1990 birth. The results of a pooled, time-series analysis reveal that medical board restrictions on physician's practices increased substantially following the creation of the Data Bank. We conclude that the increase was likely due to the licensing boards taking actions against delinquent physicians who had previously slipped through cracks in the regulatory system or who had earlier received warnings or administrative fines. [ABSTRACT FROM AUTHOR]

This article evaluates the impact of changes in tort laws on state medical licensing board actions in the United States, an area of study that has largely been overlooked in the tort reform debate. We employ negative binomial models with random effects to ascertain the impact of the passage of individual tort reforms, additional explanatory variables, and period effects on board licensing actions. Our results suggest that alterations to states' joint and several liability rules, the enactment of penalties for frivolous lawsuits, and the establishment of the National Practitioner Data Bank may have increased the use of serious sanctions by medical licensing boards, while implementation of arbitration and attorney fee regulation may have decreased their use. We call for greater attention to be paid to the impact of tort reforms on licensing actions. [ABSTRACT FROM AUTHOR]

Fully 23 years after enactment of the Health Care Quality Improvement Act and 19 years after initiation of the National Practitioner Data Bank reporting requirements, the identification and proper processing of adverse privileging actions continues to be a dynamic, challenging, and rights-preserving system at the forefront of the quality assurance initiatives, both within and outside of the Department of Defense. This article addresses the more pressing legal and practical implications of compliance in the adverse clinical privileging actions forum from the Army Medical Department military treatment facility command perspective. [ABSTRACT FROM AUTHOR]

Abstract: Medical malpractice rates against advance practice nurses (APNs) are increasing. The 2006 annual report from the National Practitioner Data Bank reported 6208 claims involving APNs. Although many APNs may not believe that they will be involved in a medical malpractice lawsuit, the statistics indicate that this is not the case. It is therefore imperative that APNs be prepared for medical malpractice legal proceedings. The purpose of this article is to review the essential terminology and instructions relating to legal proceedings in a medical lawsuit so that APNs are prepared for a deposition or court appearance. [Copyright &y& Elsevier]

Abstract: The paper presents an application of the analytic hierarchy process (AHP) methodology to support the complex decision making process concerning with the development of causal models showing how organisational knowledge assets contribute to create company’s value. The research is grounded in the resource-based view of the firm, which argues that organisational resources are bundled together. This involves difficulties in understanding which are the most important knowledge assets and how they contribute to company’s performance improvements. The application of the AHP allows to assess the weights for setting the priorities among knowledge assets against the company’s performance targets. Adopting the AHP, the knowledge assets value creation map (KAVCM) is proposed as an approach to visualise and analyse the cause-and-effect relationships linking knowledge assets with company’s performance. This allows to understand how to lever and drive knowledge assets in order to sustain company’s value creation dynamics. The application of the KAVCM is, finally, tested by its application to the identification of the knowledge assets value drivers at the basis of NPD performance improvements within an Italian leader company operating in sofa industry. [Copyright &y& Elsevier]

We estimate the effect of medical malpractice on physician behavior and health outcomes of AMI patients. The National Practitioner Data Bank (NPDB) has been combined with the Nationwide Inpatient Sample (NIS). Frequency of paid claims and claims severity are used as measures of medical malpractice risk in each state. Results suggest that an increase in medical malpractice risk leads to a reduction in resource use and improvement in health outcome for patients with less severe medical conditions. For patients with more severe medical conditions, medical malpractice is associated with an improvement in mortality. Therefore, we find no evidence that the costs of defensive medicine for most AMI patients are escalating. Threat of a malpractice lawsuit lowers the mortality rate of AMI patients, contradicting the widely held view that defensive medicine has no positive effect on health status of patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The purpose of this study was to examine child-related National Practitioner Data Bank data. METHODS. Data were obtained from the National Practitioner Data Bank. RESULTS. In the period from February 1, 2004, through December 31, 2005, a total of 30 195 malpractice payments were made on behalf of practitioners in the United States; 14% of those payments (4107 of 30 195 payments) were child related. During the period analyzed, $1.73 billion were paid for malpractice cases involving children. More than 95% of all payments were the result of settlements and only 45% the result of judgments. The average child-related malpractice payment was significantly greater than an adult-related malpractice payment ($422 000 vs $247 000); however, child-related malpractice payments were only one half as likely to occur, compared with adult-related malpractice payments. Significant geographic variability was found in the numbers and sizes of child-related malpractice payments. Failure to diagnose was the leading reason for child-related payments (18%), followed by improper performance (9%I, delay in diagnosis (9%), and improper management (6%). Finally, we found that ∼40% of all malpractice awards were the result of surgical or obstetrical issues. CONCLUSIONS. Practicing pediatricians should be aware of the existence of a mandatory electronic depository that documents all malpractice settlements and judgments involving practitioners. [ABSTRACT FROM AUTHOR]

The article evaluates the effects of previous medical malpractice tort reforms on malpractice payments and medical liability premiums. The researchers calculated the number of malpractice payments, total amount paid and average payment in every state and the District of Columbia from the National Practitioner Data Bank data reported from 1999-2001 The findings revealed that wide variations exist in malpractice payments among states.

The article presents information on the Health Care Quality Improvement Act of 1986 (HCQIA), with reference to the Diaz v. Provena Hospitals court case. The HCQIA was implemented by the Congress to improve the quality of medicare by encouraging physicians to participate in peer review and by restricting incompetent physicians' ability to move from state to state without disclosure or discovery of their previous substandard performance. For this purpose, the Congress also created the National Practitioner Data Bank, an information clearing house, that allows subsequent employers to conduct a comprehensive review of physicians' and other health care practitioners' professional credentials.

We used data from the National Practitioner Data Bank (NPDB) to study the growth of physician malpractice payments. Judgments at trial account for 4 percent of all malpractice payments; settlements account for the remaining 96 percent. The average payment grew 52 percent between 1991 and 2003 (4 percent per year) and now exceeds $12 per capita each year. These increases are consistent with increases in the cost of health care. A preoccupation with data on judgments, extreme awards, or specific specialties results in an incomplete understanding of the growth of physician malpractice payments. [ABSTRACT FROM AUTHOR]

Virtually every medical staff ensures surgeons technical competency by requiring a proctoring process. However, rarely do medical staff bylaws specify the relationship between completion of proctoring and acquisition of medical staff privileges. For this reason surgeons failing to acquire privileges because of adverse proctor evaluations might be subject to National Practitioners Data Bank reporting. Few proctors understand what their responsibilities are should they witness malpractice being committed. In the State of California, case law has demonstrated that proctors are immune from liability should they allow substandard practices to continue and fail to intervene on the patient’s behalf. Alternatively, if the proctor intervenes on a Good Samaritan basis they are most likely protected from malpractice liability. We recommend the implementation of two processes to avoid legal pitfalls: (1) Liability can be minimized if proctoring consents are obtained that clearly delineate the proctor’s responsibilities during the operation. (2) Medical staff bylaws should clearly specify the temporal relationship between application of privileges, duration of proctoring process and final acquisition of clinical privileges. [Copyright &y& Elsevier]

Focuses on the Healthcare Integrity and Protection Data Bank (HIPDB) and the National Practitioner Data Bank (NPDB), national data banks that contain records on nurses and other healthcare professionals who have had legal, disciplinary or other adverse actions taken against them. Difference between the HIPDB and the NPDB; Number of nurses reported to federal data banks.

Context: The National Practitioner Data Bank (NPDB) is believed to be an important source of information for peer review activities by the majority of those who use it. However, concern has been raised that hospitals may be underreporting physicians with performance problems to the NPDB.Objective: To examine variation in clinical privileges action reporting by hospitals to the NPDB, changes in reporting over time, and the association of hospital characteristics with reporting.Design: Retrospective cohort study of privileges action reports to the NPDB between 1991 and 1995, linked with the 1992 and 1995 databases from the Annual Survey of Hospitals conducted by the American Hospital Association.Setting and Participants: A total of 4743 short-term, nonfederal, general medical/surgical hospitals throughout the United States that were continuously open between 1991-1995 and registered with the NPDB.Main Outcome Measures: (1) Reporting of 1 or more privileges actions during the 5-year study period and (2) privileges action reporting rates (numbers of actions reported per 100000 admissions).Results: Study hospitals reported 3328 privileges actions between 1991 and 1995; 34.2% reported 1 or more actions during the period. The range of privileges action reporting rates for these hospitals was 0.40 to 52.27 per 100000 admissions, with an overall rate of 2.36 per 100000 admissions. The proportion of hospitals reporting an action decreased from 11.6% in 1991 to 10.0% in 1995 (P=.008). After adjustment for other factors, urban hospitals had significantly higher reporting than rural hospitals (adjusted odds ratio [OR], 1.21 [95% confidence interval [CI], 1.02-1.43]), while members of the Council of Teaching Hospitals of the Association of American Medical Colleges had significantly lower reporting than nonmembers (adjusted OR, 0.54 [95% CI, 0.40-0.73]). There were notable regional differences in reporting, with the east south Central region having the lowest rate per 100000 admissions (1.49 [95% CI, 1.33-1.65]).Conclusions: The results of this study indicate a low and declining level of hospital privileges action reporting to the NPDB. Several potential explanations exist, 1 of which is that the information reported to the NPDB is incomplete. [ABSTRACT FROM AUTHOR]

Objectives. This study examined hospital administrators' experiences with the National Practitioner Data Bank. Methods. One hundred forty-nine rural hospital administrators completed questionnaires assessing their perceptions of the data bank. Results. Nearly 90% of respondents rated the data bank as an important source of information for credentialing. Three percent indicated it had directly affected privileging decisions; 43% and 34%, respectively, believed the costs exceeded or equaled the benefits. Twenty percent reported changes that could decrease disciplinary action reports to the data bank. Conclusions. While the National Practitioner Data Bank is an important source of information to rural hospitals, it may affect few credentialing decisions and motivate behavioral changes that could have a paradoxical effect on quality assurance. [ABSTRACT FROM AUTHOR]

Focuses on a study which investigates the nature and scope of the difference between the Data Sharing Project conducted by the Physician Insurers Association of America (PIAA) and the National Practitioner Data Bank (NPDB), which is operated by the United States Department of Health and Human Services. Information on the NPDB; Details on the PIAA Data Sharing Project; Results of the study.

Focuses on a survey of a hospital's 66 residents to assess their understanding of the National Practitioner Data Bank (NPDB). NPDB reports as part of the process for acquiring staff privileges, professional credentials, and licenses for physicians; The small number of residents surveyed who had heard about NPDB; Other related surveys.

Evaluates the first four years of the National Practitioner Data Bank. Increase in number of voluntary queries; Number of reports contained by the end of 1994; State malpractice payment rates.

The article offers several information regarding clinical trails. It mentions that any hospital or insurance company who pays a settlementor judgment must report the name of any licensed professional on whose behalf the payment was made to the National Practitioner Data Bank (NPDB). It states that vast majority of medical malpractice cases are either dropped or settled before going to trial.

Reports developments related to disciplinary actions and malpractice cases of physicians in the United States as of January 2001. Accuracy of the data in the National Practitioner Data Bank; Information on the lawsuit filed by the insurer against a customer for reimbursement of medical expenses; Significance of the Internet for health information.

Discusses the expansion of the National Practitioner Data Bank to include other health care practitioners in addition to doctors and dentists. What must be reported; Who can or must access the Data Bank; Employers who can research unsafe practitioners; Nurses who can dispute the accuracy of incidents reported. INSET: What's in the Data Bank?.

The article reports that Federation Credentials Verification Service (FCVS) of Federation of State Medical Boards (FSMB) has rolled out a service that saves state medical boards the time and expense of querying the National Practitioner Data Bank (NPDB) during the licensure application process.