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BREAST CANCER STUDY A STUDY OF ISSUES INVOLVING THE DIAGNOSIS OF BREAST CANCER THAT RESULT IN MEDICAL MALPRACTICE CLAIMS 2002 Breast Cancer Study Focus 450 cases involving paid claims with resolution dates no earlier than January 1, 1995 were analyzed.

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breast cancer study

BREAST CANCER STUDY

A STUDY OF ISSUES INVOLVING THE DIAGNOSIS OF BREAST CANCER THAT RESULT IN MEDICAL MALPRACTICE CLAIMS

2002 breast cancer study focus
2002 Breast Cancer StudyFocus
  • 450 cases involving paid claims with resolution dates no earlier than January 1, 1995 were analyzed.
  • The study addresses only claims alleging a delay in the diagnosis of breast cancer.
  • 25 PIAA member companies reported information.
2002 breast cancer study major findings
2002 Breast Cancer StudyMajor Findings
  • More than 68% of the patients represented were under the age of 50.
  • These claims account for 78% of reported indemnity.
  • The average indemnity payment for claimants under 50 was 63% higher than for patients 50 and older.
  • Just under 33% of claimants were under 40, accounting for 43% of reported indemnity.
2002 breast cancer study major findings4
2002 Breast Cancer StudyMajor Findings
  • The patient most commonly found the lesion (59% of the cases).
  • A lesion was revealed by a screening or follow-up mammogram in 23% of the cases.
  • A physician discovered the lesion in 14% of the cases.
2002 breast cancer study major findings5
2002 Breast Cancer StudyMajor Findings
  • Radiologists were cited most frequently as defendants. One-third of all paid claims were against radiologists.
  • Radiologists are largely involved with the diagnosis of breast cancer as at least one mammogram was performed in more than 89% of the cases.
  • The average indemnity payment for radiologists in this study was $337,090.
2002 breast cancer study leading reasons for delay
2002 Breast Cancer StudyLeading Reasons for Delay
  • 45% of cases involve a misread mammogram
  • 43% reported that the findings of a physical exam failed to impress the provider
  • 40% involved a negative mammogram report
  • 36% failed to make a timely referral
  • 28% involved a communication breakdown between providers

*more than one misadventure per case

slide12

% of Claims and Indemnity

by Claimant Age Group

slide13

Average Delay in Diagnosis

by Claimant Age Group

slide15

Average Severity of Injury

by Claimant Age Group

average patient age by severity of injury
Average Patient Age by Severity of Injury

Age

NAIC Severity Code

More Severe

delay by patient
Delay by Patient

No Delay

Delay

slide19

Average Indemnity for the Period

of Delay in Diagnosis

most common physician errors
Most Common Physician Errors

Communication

bet. providers

Failure to refer

to specialist

Mammogram

report negative

Physical findings

did not impress

Mammogram

misread

most common physician errors of errors per paid defendant
Most Common Physician Errors% of Errors Per Paid Defendant

Communication

bet. providers

Failure to refer

to specialist

Mammogram

report negative

Physical findings

did not impress

Mammogram

misread

2002 breast cancer study comparisons to 1995 study
2002 Breast Cancer StudyComparisons to 1995 Study
  • The average indemnity payment increased 35% from $301,460 to $407,407. ALAE rose 58% in the same time period.
  • Negative or equivocal results in cases where a first mammogram remained at 80%.
  • The average age of claimants dropped from 46 to 45, and the median age dropped from 45 to 44.
2002 breast cancer study recommendations for all practitioners
2002 Breast Cancer StudyRecommendations forAll Practitioners
  • Document all patient complaints regarding the breast.
  • Document any family history of breast cancer.
  • Document the results of any previous mammograms.
  • Document the recommendations for subsequent diagnostic studies and follow up.
2002 breast cancer study recommendations for all practitioners28
2002 Breast Cancer StudyRecommendations forAll Practitioners
  • Remember to follow up with other physician consultants regarding test results etc.
  • A palpable mass with a negative mammogram unequivocally requires tissue diagnosis.
  • Pregnancy should not cause delay of appropriate diagnostic studies.
2002 breast cancer study recommendations for primary care physicians ob gyns
2002 Breast Cancer StudyRecommendations forPrimary Care Physicians & OB/Gyns
  • Do not abandon diagnostic pursuit because you are unimpressed by the physical findings.
  • Perform a thorough breast exam on each female patient regardless of age or complaints.
  • If a mass is palpated or suspected, additional studies must be done to rule out malignancy.
  • Perform regular follow-up exams on patients who present w/ complications of the breast.
2002 breast cancer study recommendations for radiologists
2002 Breast Cancer StudyRecommendations forRadiologists
  • Repeat mammograms that result in films of poor technical quality.
  • If the mammogram results are equivocal, recommend a repeat study, additional views, follow-up studies, other imaging modalities etc. as appropriate.
  • Be sure an adequate physical exam was performed and documented.
2002 breast cancer study recommendations for radiologists31
2002 Breast Cancer StudyRecommendations forRadiologists
  • Compare the results of any study to all previous studies.
  • Promptly report your findings to the referring physician or the patient if self-referred. The patient should be advised of any abnormality and told to consult her GP or OB/Gyn.
  • Make certain a thorough breast exam is done on self-referred patients. You are responsible for ensuring they receive proper follow-up visits.
2002 breast cancer study recommendations for surgeons
2002 Breast Cancer StudyRecommendations forSurgeons
  • Always perform an adequate examination of referred patients and document your findings, especially when they are unimpressive.
  • Make sure the correct lesion is being removed for both open and needle biopsies. Always obtain a specimen x-ray.
  • Promptly report consultation and biopsy results to referring physician.