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Professional Liability Claim Severity on the Rise for Nurses

A recent report published by the Nurses Service Organization (NSO)—an insurer of nursing professional liability and a division of CNA—finds that the severity of medical liability claims against nurses is on the rise.

The report, titled Nurse Professional Liability Exposures: 2015 Claim Report, analyzed 549 reported adverse incidents and claims involving a registered nurse, licensed practical nurse or licensed vocational nurse that closed between Jan 1, 2010, and Dec. 31, 2014, with an indemnity payment of $10,000 or greater. When possible, the authors compare the 2015 dataset with the NSO’s last report, which detailed adverse incidents and claims between Jan. 1, 2006, and Dec. 31, 2010, which was published in 2011, in order to see how the average paid indemnity amounts associated with various claim characteristics are changing over time and better identify patterns in nurse claim activity as well as litigation.

Of the 549 claims analyzed in the Nurse Professional Liability Exposures: 2015 Claim Report, 88.5 percent involved a registered nurse and 11.5 percent involved a licensed practical nurse or licensed vocational nurse. The total indemnity paid on the claims was $90,357,533.

The average paid indemnity for the 2015 dataset was $164,586, up almost 2 percent when compared to the average paid indemnity of $161,501 in the 2011 report.

For both the 2015 and 2011 datasets, the highest percentage of closed claims had a paid indemnity between $10,000 and $99,999—58.8 percent in the 2015 report and 56.2 percent in the 2011 report.

According to the 2015 report, the nurse specialties that experienced the highest severity are neurology ($538,500 average paid indemnity) and obstetrics ($397,064 average paid indemnity). The locations with the highest distribution of closed claims, accounting for 58.5 percent of all closed claims, were hospital-inpatient medical, aging services, patient’s home and hospital-inpatient surgical-service related. These findings were consistent with those from the 2011 claim report.

Of note is that the percentage of closed claims involving medication administration has declined by approximately half since the 2011 report, but the claim severity has almost doubled in the last five years.

“The decrease in claim frequency with regard to medication administration correlates with advancements in error-reduction technologies, such as bar-coding of medications and computerized order entry,” explained Jennifer Flynn, NSO manager of Healthcare Risk Management, during a Feb. 25 webinar that examined data from the Nurse Professional Liability Exposures: 2015 Claim Report. “While those technologies helped reduce the number of claims, they have increased the severity of paid claims because the offending nurse had to override those technologies in order to cause the adverse outcome. There is simply no way to defend a nurse who works around existing safeguards.”

The report’s closed claims with an indemnity of at least $1 million most frequently involved treatment and care, such as failure to comply with facility policies or operate within the nurse’s appropriate scope of practice.


Reprinted courtesy of Medical Liability Monitor, March 2016 Vol 41, No 3.

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