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June 1999
Volume 63 |
Number 6
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| Behind the Scenes
at the ASA Closed Claims Project |
Pauline Cooper, B.A.
The ASA Closed Claims Project is conducted by the ASA Committee
on Professional Liability. The project office is located at the
University of Washington, Seattle, Washington. It was started
in 1984 by Richard J. Ward, M.D., and is currently directed by
Frederick W. Cheney, M.D., with the assistance of Robert A. Caplan,
M.D., Karen B. Domino, M.D., and Karen L. Posner, Ph.D. Other
staff include Pauline Cooper, B.A., (research study coordinator),
John Campos, M.A., (computer support analyst) and Lynn Hubbard-Hamacher
(secretary). The Closed Claims database currently consists of
4,459 claims. On average, about 300 cases are collected per year.
Companies Involved
Thirty-five insurance companies across the United States currently
participate in the project. They have agreed to allow anesthesiology
reviewers to review their anesthesiology-related claims that have
closed.
Reviewers Involved
Reviewing is performed on a voluntary basis, and reviewers are
only reimbursed for travel expenses. All reviewers are members
of ASA and are in active practice. At present, approximately 15
anesthesiologists are called upon each year to conduct reviews.
The Closed Claims Project extends its special thanks to reviewers
who have surveyed 100 or more claims. These individuals include:
Patrick K. Birmingham, M.D., Bruce R. Brookens, M.D., David E.
Byer, M.D., Michael G. Cassaro, M.D., Frederick W. Cheney, M.D.,
William Gild, M.D., Anthony R. Giorgio, M.D., Sandra Jelenich,
M.D., Russell T. Wall III, M.D., Richard J. Ward, M.D., Gary W.
Welch, M.D., and Gerald L. Zeitlin, M.D.
ASA Closed Claims Process
The Closed Claims office first contacts a participating insurance
company to find out how many anesthesia claims have closed since
our previous visit to that company. Each participating insurance
company is contacted once each year. If there are enough claims
to warrant a visit, we then search for volunteer physician reviewers
from similar geographic locations to evaluate information at that
company. Reviewers travelling to destinations requiring overnight
stays are asked to participate for two to three days at a time.
All materials that the reviewers need (e.g., dataforms, instructions)
are mailed in advance to the company. At the conclusion of the
reviewers' visit, the company returns the completed dataforms
to the Closed Claims office via express mail, where the dataforms
are then given a unique identification number. All identifiers
are removed from the dataform to ensure anonymity and confidentiality
of the company and the other parties involved in the claim. Finally,
the ASA Closed Claims committee reviews the dataforms for consistency
and missing information. Each January, claims from company visits
that have undergone the complete review process are incorporated
into the overall database for analysis.
Company and Reviewer Acknowledgments
Of the 35 companies that have contributed to the Closed Claims
Project database, the following 25 organizations have given permission
for acknowledgements as a source of closed claims: Anesthesia
Services Medical Group, Inc., California; Anesthesiologists Professional
Assurance Trust, Florida; Armed Forces Institute of Pathology;
Controlled Risk Insurance Company (Harvard); COPIC Insurance Company,
Colorado; Doctors' Company; Illinois State Medical Inter-Insurance
Exchange; Massachusetts Medical Professional Insurance Association;
Medical Association of Georgia Mutual Insurance Company; Medical
Inter-Insurance Exchange of New Jersey; Medical Liability Mutual
Insurance Company of New York; Medical Mutual Insurance Company
of Maine; Midwest Medical Insurance Company; Mutual Insurance
Company of Arizona; National Capital Reciprocal Insurance Company;
NORCAL Mutual Insurance Company, California; Pennsylvania Medical
Society Liability Insurance Company; PHICO Insurance Company,
Ohio; Preferred Physicians Mutual Risk Retention Group; St. Paul
Fire and Marine Insurance Company; State Volunteer Mutual Insurance
Company, Tennessee; University of Texas Medical System; Utah Medical
Insurance Association; Veterans Administration; and Washington
State Physicians Insurance Exchange Association.
The following 52 anesthesiologist reviewers have given permission
for acknowledgement as claims reviewers in recent years: Bruce
R. Baird, M.D., R. Dennis Bastron, M.D., Patrick K. Birmingham,
M.D., James F. Black, M.D., John T. Bonner, M.D., Bruce R. Brookens,
M.D., David E. Byer, M.D., Edgar D. Canada, M.D., Robert A. Caplan,
M.D., Michael G. Cassaro, M.D., H.S. "Cliff" Chadwick, M.D., Frederick
W. Cheney, M.D., Melvin A. Cohen, M.D., Shep Cohen, M.D., Michael
F. Cristoforo, M.D., Fred G. Davis, M.D., Alberto J. DeArmendi,
M.D., David M. Dewan, M.D., Karen B. Domino, M.D., Richard M.
Dsida, M.D., John H. Eichhorn, M.D., Herbert M. Epstein, M.D.,
Herbert A. Ferrari, M.D., Jeremy M. Geiduschek, M.D., James S.
Gessner, M.D., Anthony R. Giorgio, M.D., Ronald J. Gordon, M.D.,
Douglas S. Hagan, M.D., Henri S. Havdala, M.D., Peter L. Hendricks,
M.D., William D. Hetrick, M.D., Richard N. Hindin, M.D., Rosemarie
M. Johnson, M.D., Robert E. Kettler, M.D., Donald A. Kroll, M.D.,
Gary H. Morton, M.D., Rodney C. Osborn, M.D., Lee S. Perrin, M.D.,
William C. Petty, M.D., M. Ramez Salem, M.D., L. Anthony Simons,
M.B., Stephen R. Strelec, M.D., Daniel R. Sullivan, M.D., Neil
Swissman, M.D., Philip Villandry, M.D., Jordan Waldman, M.D.,
Russell T. Wall III, M.D., Edward S. Wegrzynowicz, M.D., Maxwell
Weingarten, M.D., Gary W. Welch, M.D., Harry C. Wong, M.D., and
Jay H. Yedlin, M.D.
We greatly appreciate the efforts of all participating companies
and reviewers that have contributed to the Closed Claims Project.
Pauline Cooper, B.A., is the Research
Study Coordinator for the ASA Closed Claims Project, University
of Washington School of Medicine, Seattle, Washington.
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