The article by Cheney et al1 in this issue of The Journal represents a unique approach to the study of the outcome of medical care. A database of more than 1000 medical malpractice lawsuits related to anesthetic care was assembled from the closed claims files of 17 insurance companies willing to cooperate with the Committee on Professional Liability of the American Society of Anesthesiologists, under whose auspices the study was conducted.
This is not the first time that the resource of malpractice closed claims has been used to evaluate the outcome of medical care. Caplan et al,2 in a study of the first 900 closed insurance claims from the current database, identified 14 cases of sudden unexpected cardiac arrest during spinal anesthesia accompanied by heavy sedation. Previously, the National Association of Insurance Commissioners, in cooperation with member societies of the Council of Medical Specialty Societies, conducted an extensive
Brunner EA. Monitoring Anesthetic Care: New Directions. JAMA. 1989;261(11):1633. doi:10.1001/jama.1989.03420110109033
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