Obesity malpractice claims up 64% in five years
Obesity-related lawsuits against providers have risen 64% in six years, according to a claims analysis by national medical liability insurer The Doctors Company, based in Napa, CA. Claims associated with obesity totaled 415 between 2007 and 2012, an increase of 64% in the number of such lawsuits from the period between 1992 and 2002.
The Doctors Company offers these tips for reducing obese malpractice claims:
• Communicate. Have open and clear communications. Obese patients should be warned of all the hazards associated with being overweight, including the nature and frequency of possible complications.
• Document. Document any and all discussions you have with a patient related to the need for weight loss.
• Manage closely. Provide intensive patient management. Develop criteria for preop management of the obese patient. Criteria are especially valuable for elective procedures.
• Delay surgery. When the patient doesn’t meet the recommended criteria, suggest a delay in elective surgeries, with weight loss as a goal.
• Obtain assistance from other specialties. If faced with an emergent or urgent surgery, obtain as much help as possible from appropriate consultants in medicine, endocrinology, anesthesia, and other fields.
• Strengthen the informed consent process. A medication treatment plan should include an informed consent discussion on how the medication works, side effects a patient might experience, and the expected weight loss. Ensure the medical record properly reflects this discussion.
Discuss and document risks, benefits, and alternatives to treatment. The informed consent process becomes even more significant on emergent or urgent procedures. Convey the additional risks and complications, as appropriate to the procedure and patient’s size.
• Always perform bariatric surgery in a hospital. Even when performed laparoscopically, bariatric surgery is almost always undertaken in a hospital setting. It requires properly trained and experienced staff in an operating room environment specifically designed to accommodate morbidly obese patients. Claims arising from bariatric surgery performed outside a hospital setting can be difficult to defend.
• Be certain. When in doubt, don’t perform the procedure. More information on the study can be found online at http://tinyurl.com/pzaepyd.
