Volume 40 Supplement 1

70th Congress of the Italian Society of Pediatrics

Open Access

Pediatric claims in Italy during a 8-years survey

  • Rino Agostiniani1,
  • Antonio Correra1,
  • Paolo D’Agostino1,
  • Ernesto D’Aloja1,
  • Luigi Greco1,
  • Paolo Tagliabue1,
  • Vassilios Fanos1 and
  • The Risk Management Commission of the Italian Society of Pediatrics1
Italian Journal of Pediatrics201440(Suppl 1):A87

DOI: 10.1186/1824-7288-40-S1-A87

Published: 11 August 2014

Very few data are available on pediatrics malpractice claims. We report the first data obtained in Italy on pediatrics regarding a wide population study during a 8 years survey. Data concerning 164 claims are presented and discussed. Our data suggest how big is the problem and they may be helpful to face it.

Introduction

Pediatrics is not a high-risk specialty in terms of the number of claims, although some of the largest financial payouts have been for multiple disabled children with perinatal injuries and long life expectancy [15]. We report the first data obtained in Italy on pediatrics regarding a wide population study.

Materials and methods

We conducted a retrospective, descriptive analysis of a nation-wide database on pediatric malpractice claims, in which patients alleged a permanent impairment related to a medical misconduct. The Italian Society of Pediatrics (Società Italiana di Pediatria; SIP) has developed a link – thorough insurance broker Willis Italian SpA – with an insurance company (CARIGE Assicurazioni SpA) that insures a wide proportion of Italian pediatricians (nearly 60% out of 8000 physicians).

We asked Willis to perform a query of its database, looking at malpractice claims reported between January, 1st 2005 and December, 31st 2012 involving pediatrics while avoiding neonatology.

Definitions are used as previously reported by ours [6].

Results

We found 164 claims, the majority of which were reported in the last two years (year 2011: n=65; year 2012: n=35), covering more than 2/3 of the total number of claims. 89 were from South Italy, 43 form the north and 32 from Central Italy. 141 involved the public health system, 13 the private health system and 8 family pediatricians. 102 were criminal actions, 53 civil actions, 5 mixed actions and 4 cautelative claims. We found 89 death claims and 65 claims for permanent impairment. Each claim interested one or more physicians. Main areas of class are presented in table 1. Among surgical pathologies, 6 were gastrointestinal and 6 involved testis. Among infections, 6 were pleura-pulmonary diseases, 5 fulminant sepsis (2 meningococcal), 3 tuberculosis (2 meningeal, 1 pulmonary), 1 Salmonellosis, 1 Candidosis, 1 chicken pox, 1 scarlet fever.
Table 1

Main area of claims in the 8 years-survey

Main area of claims

Number of claims

Surgical pathology

26

Infections

20

Gastrointestinal medical problem (vomiting, diarrhea) with subsequent dehydration

14

Iatrogenic pathology (drugs, catheters…)

5

Undiagnosed tumor

4

Undiagnosed congenital cardiopathy

3

Post vaccinal encephalitis

3

Undiagnosed urinary disease

2

Undiagnosed rare disease

2

Undiagnosed deafness

2

Conclusions

Malpractice data can be used to identify problem-prone clinical processes and suggest interventions that may reduce errors. Continual medical education should be oriented in areas of claims also improving physician communication skills [7].

Authors’ Affiliations

(1)
Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU and University of Cagliari

References

  1. Marcovitch H: When are paediatricians negligent?. Arch Dis Child. 2011, 96: 117-120. 10.1136/adc.2010.195784.View ArticlePubMedGoogle Scholar
  2. Selbst SM, Friedman MJ, Singh SB: Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005, 21: 165-169.View ArticlePubMedGoogle Scholar
  3. Kain ZN, Caldwell-Andrews AA: What pediatricians should know about child-related malpractice payments in the United States. Pediatrics. 2006, 118: 464-468. 10.1542/peds.2005-3112.View ArticlePubMedGoogle Scholar
  4. Carroll AE, Buddenbaum JL: Malpractice claims involving pediatricians: Epidemiology and etiology. Pediatrics. 2007, 120: 933-935.Google Scholar
  5. Ozdemir MH, Ergönen TA, Can IO: Medical malpractice claims involving children. Forensic Sci Int. 2009, 191: 80-85. 10.1016/j.forsciint.2009.06.014.View ArticlePubMedGoogle Scholar
  6. Tagliabue P, Greco L, Agostiniani R, Carbone MT, D'Agostino P, Correra A: Neonatal malpractice claims in Italy: how big is the problem and which are the causes?. J Matern Fetal Neonatal Med. 2012, 25: 493-7. 10.3109/14767058.2011.622004. doi: 10.3109/14767058.2011.622004View ArticlePubMedGoogle Scholar
  7. D'Aloja E, Floris L, Muller M, Birocchi F, Fanos V, Paribello F, Demontis R: Shared decision-making in neonatology: An utopia or an obtainable goal?. J Matern Fetal Neonatal Med. 2010, 23 (Suppl 3): 56-58. 10.3109/14767058.2010.509913.View ArticlePubMedGoogle Scholar

Copyright

© Agostiniani et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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