• Aladine A Elsamadicy, Amanda R Sergesketter, Michael D Frakes, and Shivanand P Lad.
• Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
• Neurosurgery. 2018 Nov 1; 83 (5): 997-1006.

BackgroundDue to disparaging costs and rates of malpractice claims in neurosurgery, there has been significant interest in identifying high-risk specialties, types of malpractice claims, and characteristics of claim-prone physicians.ObjectiveTo characterize the malpractice claims against neurosurgeons.MethodsThis was a comprehensive analysis of all malpractice liability claims involving a neurosurgeon as the primary defendant, conducted using the Physician Insurers Association of America Data Sharing Project from January 1, 2003 and December 31, 2012.ResultsFrom 2003 to 2012, 2131 closed malpractice claims were filed against a neurosurgeon. The total amount of indemnity paid collective between 1998 to 2002, 2003 to 2007, and 2008 to 2012 was $109 614 935, $140 031 875, and $122 577 230, respectively. Of all the neurosurgery claims, the most prevalent chief medical factor was improper performance (42.1%, $124 943 933), presenting medical condition was intervertebral disc disorder (20.6%, $54 223 206), and operative procedure performed involved the spinal cord and/or spinal canal (21.0%, $62 614 995). Eighty-five (22.91%) of the total neurosurgery claims resulted in patient death, resulting in $32 067 759 paid. Improper performance of the actual procedure was the most prevalent and highest total paid cause for patient death ($9 584 519).ConclusionFrom 2003 to 2012, we found that neurosurgery malpractice claims rank among one of the most costly and prevalent, with the average indemnities paid annually and the overall economic burden increasing. Diagnoses and procedures involving the spine, along with improper performance, were the most prevalent malpractice claims against neurosurgeons. Continued medical malpractice reform is essential to correct the overall health care cost burdens, and ultimately improve patient safety.

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