Analysis of Closed Claims Among All Medical Specialties: Importance of Communication and Other Non-Clinical Contributing Factors

Fred Kusumoto,1 Jacqueline Ross,2 Dan Wright,2 Richard A Chazal,3 Richard E Anderson2 1Heart Rhythm Service, Department of Cardiovascular Disease, Mayo Clinic, Jacksonville, FL, USA; 2The Doctors Company, Napa, CA, USA; 3Lee Health Heart and Vascular Institute, Fort Myers, FL, USACorrespondence: Fred Kusumoto, Heart Rhythm Service, Department of Cardiovascular Disease, Mayo Clinic, 4500 San Pablo Ave, Jacksonville, FL, 32224, USA, Tel +1904 953-7277, Email Kusumoto.fred@mayo.eduObjective: Medical malpractice claims represent patient dissatisfaction of care delivered by their healthcare provider. Evaluation of contributing factors (CFs) associated with claims provides important information to optimize the patient–provider relationship.Study Design: A total of 21,101 closed claims with 54,479 CFs (2.2 contributing factors per claim) from a large medical professional liability coverage provider were analyzed from 2010 to 2019.Results: Four clinical CFs (technical performance, management of therapy, patient assessment, and patient factors) and four nonclinical CFs (communication between providers and patient, communication among providers, failure or delay in obtaining a consult, and insufficient documentation) were identified > 1,500 times. Nonclinical CFs increased as a percentage from 50% in the first part of the study period to 54% in the second part of the study period (p < 0.01), and were more frequent in cases associated with indemnity when compared to clinical CFs (Nonclinical: 57% vs 43%; p < 0.001). Poor communication as a CF increased steadily during the study period (3-year average; 2010– 2012: 777 CF/year vs 2017– 2019: 1207 CF/year; p < 0.001). In claims associated with high severity injury, poor communication among providers was more significant than poor communication between the provider and patient (63% vs 29%; p < 0.001), mainly due to failure to convey the severity of the patient’s condition. For non-surgical specialties except