State Patient Compensation Funds for Medical Malpractice

By October 26, 2017Health

While many specialty providers will face a medical malpractice suit at one time in their careers, anesthesiologists are higher on the risk spectrum to be subject to a claim. Anesthesiologists continue to be subject to among the highest of medical malpractice claims, with an average paid indemnity of about $100,000.[1] There are a variety of reasons that a patient may submit a claim against an anesthesiologist, and these reasons are heightened with a dramatic event during an unsuccessful surgery: for example, an airway collapse or a drug overdose. While the most likely reason for a patient to submit a claim against an anesthesiologist is due to injury, patients may also submit claims based on actions of medical error, lack of medical information on the part of the patient, or failure to treat.[2] When considering medical malpractice in the anesthesia field, it is also necessary to consider the role and responsibilities of Certified Registered Nurse Anesthetists (CRNAs).  CRNAs are often under the supervision of anesthesiologists or surgeons, such that in an event of potential medical malpractice the supervising physician is held responsible.[3] However, national regulations do exist to address claims against CRNAs.  In most states, the typical liability limit for CRNAs are $1,000,000 per claim and $3,000,000 total.[4] CRNAs may also participate in a medical malpractice insurance plan offered by his or her associated hospital network. Overall, the medical malpractice space is more highly dependent on individual claims, as little precedent has been set for the CRNA case.

 

 

In cases of medical malpractice, including for anesthesia services, the government may step in to resolve medical malpractice claims between the patient and the physician. On a state basis, Patient Compensation Funds (PCFs) are utilized in cases of medical malpractice. Essentially, these funds grant compensation to patients and/or patient’s families that have fallen subject to a medical error or omission by a physician that is in the associated state PCF system. The state then agrees to allocate and manage the PCF by collecting insurer surcharges and enrolling physicians in the fund. The state also designs specific methods to decide how and to whom the PCF can be granted.[5] For example, New Mexico, Nebraska, Wisconsin, and Indiana have specific caps in place to restrict the individual or total award amounts granted by the Fund. More qualitative regulations may also be in place, such as in South Carolina, which requires the patient to receive specific medical information about the course of the case before formally pursuing the claim. Ideally, PCFs act as an important middleman, providing for the effective release of compensation to the patient while also minimizing social and financial impact on the provider. PCFs are therefore an effective tool to continue improving the paradigm of care in the healthcare system, thus ensuring that patients are provided for, and that physicians are encouraged to continue to raise the standard of care.

[1] https://www.insurance.wa.gov/sites/default/files/documents/2016-med-mal-annual-report.pdf

[2]  http://www.medscape.com/features/slideshow/malpractice-report-2015/

[3] https://biotech.law.lsu.edu/books/lbb/x943.htm

[4] http://www.aana.com/insurance/Documents/understanding-crna-malpractice-insurance101-practice.pdf

[5] http://via.library.depaul.edu/cgi/viewcontent.cgi?article=1396&context=law-review

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