The Ultimate Medical Malpractice Insurance Guide
Mar 26, 2024
In this chapter of our Medical Malpractice Insurance Guide, we’ll share some real examples of medical malpractice cases involving various healthcare professionals. Ideally, these case studies will give you a better understanding of medical malpractice, how it can happen, and the potential consequences. Without further ado, let’s dive in.
Medical malpractice is a serious concern, leading to severe consequences for patients and practitioners. The U.S. Department of Health and Human Services reported 38,938 adverse action reports against healthcare practitioners in 2022.
The 2021 Medscape Malpractice Report notes that failure to diagnose or delayed diagnosis is the leading cause of malpractice lawsuits, at 31%. Following closely behind, medication errors cause 29% of malpractice cases, while poor outcomes or disease progression account for 26%. The same report also lists the most common specialties to be sued, which we’ve listed here:
It’s important to note that malpractice lawsuits aren’t limited to physicians alone. According to Nurse Journal, about 18% of cases closed between 2018 and 2021 included nurses, nursing assistants, and nursing students. However, physical therapists (PTs), occupational therapists (OTs), physician assistants (PAs), and optometrists (ODs) can all be held responsible for medical malpractice.
Here are some real-life examples of medical malpractice cases against allied healthcare professionals.
This example of malpractice is from a unpublished case opinion issued by the Minnesota Court of Appeals on December 14, 2020. In this case, a nurse failed to report a change in the patient’s condition.
A 62-year-old female patient with a history of abdominal surgeries, including gastric bypass surgery, visited the emergency department (ED) due to abdominal pain and vomiting. Her lungs were clear, but she was admitted for pain and nausea, and IV fluids were given to rehydrate her. After a few days, the patient was diagnosed with constipation.
Two days later, the patient continued to experience symptoms, and the nurse noted she was “spitting up into an emesis bag” and had “dry heaves.” Another physician examined her, confirmed the constipation diagnosis, and said she was breathing “normally.” This physician scheduled her for transfer the following day to another hospital.
During the night, the patient vomited multiple times and expressed abdominal discomfort. She had another emesis during the night with a faint bowel odor, but the RN did not notify a doctor.
After being transferred the next morning, a CAT scan revealed a bowel obstruction and evidence of pneumonia. Antibiotics were administered, but her condition deteriorated. The following day, she died from “pneumonia as a result of aspiration.”
A wrongful death lawsuit was filed against the hospital and healthcare staff who treated the patient. According to the jury, the hospital nurses were negligent in failing to report the change in the patient’s condition, and the son was awarded $500,000. However, the trial court later granted judgment for the hospital and ordered a new trial. The son appealed the decision.
The appellate court later reversed the lower court’s decision and reinstated the jury verdict in the son’s favor.
Medical malpractice insurance can provide financial protection and support to help you navigate the legal consequences and potential liabilities resulting from a medical negligence lawsuit like this one. It can help cover legal expenses, such as attorneys’ fees, court costs, and any settlement or damages awarded to the plaintiff.
Additionally, as in this case, the insurance provider may offer guidance throughout the legal process, ensuring the nurse’s rights and interests are protected.
Malpractice claims against PAs in the emergency department (ED) have increased in recent years. Here is one example.
In the ED, a patient was under the medical care of a PA who diagnosed them with cellulitis and prescribed antibiotics. The patient was discharged from the ED without being examined by the emergency physician (EP).
However, 12 hours later, the patient was brought back to the ED by ambulance and readmitted with acute arterial occlusion. In order to treat the patient’s condition, both legs below the knee were amputated.
The patient’s readmission and amputation led to an investigation and legal action. The patient sued the PA, the EP, and the hospital. During the legal proceedings, several questions were raised about the PA’s initial diagnosis and treatment, including triaging the patient as non-urgent and not ordering diagnostic tests. A significant factor was the EP’s failure to examine the patient personally.
The jury awarded the patient $5 million as a result of the negligence alleged in the case.
Having appropriate medical malpractice insurance coverage is crucial for all healthcare professionals. In this case, it could help mitigate the burden on the PA, the supervising physician, and the hospital. Without coverage, the financial repercussions could have been devastating for all parties involved.
This medical malpractice case story involves a post-kidney transplant nurse who told the Berxi reporter that she thought her job wasn’t very risky. She learned she didn’t have medical malpractice insurance after being named in a claim.
When a male transplant patient was being discharged, the nurse prepared instructions on post-transplant care, including medication instructions, potential complications, follow-up appointments, and contact numbers for reporting issues. Unfortunately, the nurse made a critical mistake by recording the wrong dosage for the patient’s anti-rejection medication, which could jeopardize the success of the transplant.
Three days after discharge, the patient’s wife expressed concerns about her husband’s fever and discomfort, leading to his readmission. Kidney rejection was confirmed during the hospital stay. Despite treatment to prevent rejection, the patient’s kidney function remained compromised, resulting in a 45-day hospitalization that disrupted his life and required long-term monitoring for the transplanted kidney.
A few months later, a medication error was discovered, prompting the patient to request an internal investigation into the cause of his distress. The hospital’s legal team informed the nurse that a lawsuit would likely be filed. As an independent contractor through a nurse staffing agency, the nurse did not have access to the hospital’s malpractice insurance — it covered employees only.
A year-long legal process resulted in a settlement of $1.5 million for the patient. Because the surgeon performing the transplant and the hospital were also at fault, the nurse’s share of the settlement was 33%, or $495,000, on top of her legal expenses.
The nurse mistakenly thought medical malpractice insurance was needed only for bedside nurses, not those working in office environments. However, the legal costs in this case quickly disproved that misconception.
Medical malpractice insurance provides crucial protection by covering legal expenses, such as attorneys’ fees, court costs, and settlement amounts. The legal expenses and $495,000 settlement contribution could have been covered by a $1 million/$3 million limit medical malpractice policy.
In this medical malpractice example, a physical therapist is accused of reinjuring a patient. The Court of Appeals of Michigan issued this unpublished opinion on November 23, 2021.
An adult male injured his shoulder while moving a television in January 2014. In May 2016, he underwent surgery to repair the injury and was prescribed physical therapy. About four months after surgery, an incident occurred during physical therapy.
During the session, the PT attending to the patient was “drawn to an adjacent area” to assist another individual, leaving the patient in the care of an unlicensed rehabilitation technician. As the technician continued the prescribed exercises, the patient “became nauseous and overcome with pain.” Following the session, an ice pack was given to the patient, and he drove himself home.
However, the patient reported that his shoulder condition deteriorated further over time, eventually requiring a second surgery.
The patient filed a lawsuit against the physical therapy clinic itself, the physical therapist responsible for his care, and two other employees who were involved in his treatment. He claimed that the physical therapy exercises he received at the clinic led to a reinjury of his shoulder.
In an affidavit, the surgeon who performed both shoulder surgeries for the patient stated that the specific physical therapy exercises were not responsible for the reinjury of the shoulder. The trial court granted summary disposition in favor of the defendants, effectively dismissing the patient’s claims.
The patient then filed an appeal. The appellate court agreed with the trial court’s conclusion that the patient had not provided sufficient evidence to establish that the defendants were responsible for his reinjury. As a result, the initial decision to grant summary disposition in favor of the defendants was upheld.
In this case, medical malpractice insurance could have played a significant role in protecting the defendants and potentially mitigating their financial risks. Medical malpractice insurance typically covers legal expenses, including attorneys’ fees and court costs. However, another essential aspect to consider is coverage for expert witness fees, which hold significant importance in medical malpractice cases.
A rushed discharge assessment by an OT led to tragic consequences and triggered a lawsuit, highlighting the importance of medical malpractice insurance coverage for healthcare professionals.
An OT was asked to cover the remaining patients for another therapist who had to leave early. Worried about working overtime without approval, the OT hurried through a discharge assessment without following the usual procedure. She overlooked the vital detail of ensuring the patient had safe equipment for showering at home.
The patient was discharged. Tragically, the patient was found unresponsive on the bathroom floor three days later.
The patient’s family filed a lawsuit against the OT, alleging negligence in the discharge assessment. It claimed that her failure to ensure that proper safety equipment was installed before discharge directly caused the patient’s death. The OT didn’t have medical malpractice insurance coverage and faced the burden of getting legal representation alone.
At the trial, the jury determined that the OT had to pay the patient’s family $400,000. Lacking insurance, she was forced to sell her home and car and ultimately declared bankruptcy.
Medical malpractice insurance would have provided financial protection and support for the OT. Policies are designed to cover legal costs and settlement amounts. If this OT had had coverage, she might not have had to sell assets or declare bankruptcy.
Insurance also could have helped the OT navigate the legal proceedings with more confidence and protect her personal and professional well-being.
Read more medical malpractice case studies told by the medical professionals who were sued:
Medical mistakes can happen in any setting, whether you’re a seasoned healthcare professional or a new practitioner. Medical malpractice claims can arise from diagnosis errors to treatment complications, even when you have the best intentions and provide the highest standard of care. That’s why it’s essential to have medical malpractice insurance. It could protect you from the financial and reputational damage of a malpractice suit.
With the right insurance policy, you can have peace of mind knowing you’re protected in case of a lawsuit. Having medical malpractice insurance from Berxi can cover the cost of legal fees, settlements, and court representation if you make a mistake (or if someone claims you did).
At Berxi, we believe every healthcare professional deserves the protection and support they need. That’s why we offer comprehensive medical malpractice insurance policies that can cover a wide range of claims, including errors in diagnosis, medication, or treatment. While you may have coverage under your employer, a Berxi policy can help supplement your existing one to cover gaps in coverage that their employer’s policy might not have.
In the next chapter of this guide, we’ll dive deeper into the statute of limitations on medical malpractice lawsuits.
Image courtesy of iStock.com/masterzphotois
Robyn Correll, MPH contributed to this article
Last updated on Mar 26, 2024.
Originally published on Apr 27, 2020.
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