January 1, 2013
Volume 77, Number 1
Greetings From the Committee on Professional Liability!
Karen B. Domino, M.D., M.P.H., Chair Committee on Professional Liability
This issue of the ASA NEWSLETTER is devoted to articles by members of the Committee on Professional Liability. Our mission is to improve anesthesiologists’ understanding of medico-legal affairs and design programs to prevent medical malpractice claims. Several noteworthy articles span our committee’s mission.
Ronald Litman, M.D. reviews the ethical and legal considerations for prescribing medications for self and family members. Christopher Burkle, M.D., J.D. reports on the
Oregon Safe Harbor Study Results and asks the question: Is there hope for improved medical liability transparency
through use of guidelines? As shared decision-making enters the medico-legal realm, Colleen O’Leary, M.D. looks again at the informed consent process.
Prevention of Medical Malpractice Claims
Our committee directs the Closed Claims Project and associated registries, including the Postoperative Visual Loss Registry and the Anesthesia Awareness Registry. Two articles in this issue are the result of closed claims analysis. Lorri Lee, M.D. describes factors associated with postoperative respiratory depression from opioids, which remains a significant cause of high-severity injuries for patients. In the closed claims files, Dr. Lee found modes of pain control, multiple prescribers and monitoring during a high-risk postoperative period to be important sources of error. Sonya Mehta, M.D. describes burn injuries from warming devices in the operating room. Proper attachment of the appropriate blanket device to the hose of the warming unit and avoidance of use of heated intravenous fluid bags for positioning and warming purposes can stop these preventable injuries.
Services for ASA Members
As a service to ASA members, we perform customized data searches of the Closed Claims Project database for educational, quality-improvement and risk-management purposes. We can also provide selected pre-existing slides for use in educational and risk-management presentations. Karen Posner, Ph.D. (email@example.com) is project manager. She will work with you to clarify data needs and ascertain whether we have data relevant to your question. We can provide a brief, customized report that may include de-identified claim summaries to illustrate various clinical situations relevant to the topic. Information from our report may be presented locally, such as an M&M conference, and may be included in grant applications. It may be used in risk-management activities, such as case review prior to litigation, or in local quality-improvement activities. Any broader use of customized data reports requires prior approval. A data request form is available on the project website (www.asaclosedclaims.org) and must be completed in order to receive a report. If your research question requires more complex analysis than provided through the data request service, then collaboration with the project team may be an option.
Our committee also conducts a yearly survey of trends in liability insurance for anesthesiologists, which is published in the ASA NEWSLETTER in October.1 We have an educational “Manual on Professional Liability,” a primer on important issues dealing with medical malpractice, about which all anesthesiologists should be knowledgeable. It is available on the ASA website at https://ecommerce.asahq.org/p-136-professional-liability-and-the-anesthesiologist.aspx.
This URL takes you to the “Physician Booklets” section where you can add the manual to your shopping cart and then download a single copy at no charge.
Please let me know what else our committee can do to better serve you, the ASA membership. I can be reached most easily via email at firstname.lastname@example.org.
Karen B. Domino, M.D., M.P.H. is
Professor of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle.
1. Domino KB. Professional liability insurance: are higher policy limits better for some anesthesiologists? ASA Newsl. 2012;76(10):40-42.