November 23, 1994

The Relationship Between Malpractice Claims History and Subsequent Obstetric Care

Author Affiliations

From the Departments of Obstetrics and Gynecology (Dr Entman and Ms Glass), Pediatrics (Dr Hickson), and Economics (Ms Githens and Dr Sloan), Vanderbilt University Medical Center Nashville, Tenn, and the Center for Health Policy Research and Education, Duke University, Durham, NC (Dr Whetten-Goldstein). Ms Githens is now with Indiana University, Indianapolis. Dr Sloan is now with Duke University.

JAMA. 1994;272(20):1588-1591. doi:10.1001/jama.1994.03520200044033

Objective.  —To determine the relationship between prior malpractice claims experience and the quality of clinical obstetric care.

Design.  —Historical cohort study of obstetricians, classified by their prior malpractice claims experience, with blinded review of medical records from their practices 5 to 10 years later.

Setting.  —Florida obstetricians who lost, settled, or defended malpractice claims between 1977 and 1983 and who were still practicing obstetrics in 1987.

Main Outcome Measures.  —Objective and subjective assessment of quality of clinical care of patients attended by obstetricians with different histories of malpractice claims.

Results.  —No differences were found in any of the objective or subjective measures of the quality of clinical care provided to patients of obstetricians who were classified into one of four groups according to their prior claims history.

Conclusions.  —No relationship was found between prior malpractice claims experience and the technical quality of practice by Florida obstetricians. Strategies that attempt to identify physicians at risk for future clinical errors by using data on prior malpractice claims (such as the National Practitioner Data Bank) may be misjudging the likelihood that substandard clinical care will be provided by physicians with prior claims.(JAMA. 1994;272:1588-1591)