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Why Do Physicians Who Treat Lung Cancer Get Sued?

^* Dr. McLean is CEO, Third Millennium Consultants, LLC, Shawnee, KS.

Correspondence to: Thomas R. McLean, MD, JD, FCCP, Esq., Third Millennium Consultants, LLC, 4970 Park, Shawnee, KS 66216; e-mail: tmclean{at}dnamail.com

Background: Minimal information exists on why malpractice actions are filed against physicians who treat lung cancer.

Objective: To review currently available data on lung cancer malpractice litigation to develop litigation-avoidance strategies.

Design: A retrospective review of a publicly available database containing verdicts and settlements of malpractice cases. Data were then compared to the Physician Insurers Association of America (PIAA) Lung Cancer Study, which was published in 1992. The PIAA report is considered the best available data on malpractice and lung cancer.

Results: There were 89 patients in the current study and 213 patients in the PIAA study. Physicians are most often sued by patients in their 50s (mean age, 58.9 years; range, 34 to 80 years [current study]; vs 55 years; range, 17 to 75 years [PIAA study]). Primary care physicians (60% cases in the current study vs 33% cases in the PIAA study) and radiologists (20% cases in the current study vs 55% cases in the PIAA study) were named as defendants in > 75% of suits. Failure to diagnosis lung cancer was the most common reason physicians were sued (80% case in the current study vs 23.3% cases in the PIAA series). Despite the similarity in litigation profiles, the mean award to plaintiffs, in constant dollars, increased from $172,271 in the PIAA study to $632,261 in the current study.

Conclusions: (1) Recommended strategies to avoid litigation depend on physician subspecialties. While primary care physicians would benefit most from setting up a chest radiograph tracking system, radiologists would benefit most from initiating a continuous quality improvement system to substantially decrease the misinterpretation rate of chest radiographs. (2) Over the past 12 years, there appears to have been a substantial increase in awards to patients with lung cancer who sue their physicians. However, this finding may be artificial because of differing study design. Further investigation on this subject is recommended.

Key Words: litigation • lung cancer • malpractice

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