In late April, UK breast surgeon Dr. Ian Paterson was found guilty of 17 counts of “wounding with intent,” throwing a spotlight on the topic of multiple patient injuries and how they affect insurers and health care providers.
One bad actor, millions in costs
In addition to the 10 victims involved in this case, Paterson had previously carried out hundreds of unnecessary operations on National Health Service patients. A hospital trust had already paid out some £17.8m in damages and legal costs in those cases. As other claims come in, it is conceivable that the total compensatory damages will eventually exceed £100m.
These numbers illustrate how a series of medical errors, whether deliberate or otherwise, and involving just a single medical professional, can escalate dramatically, both in terms of the number of victims involved and the attendant financial cost. These include legal and defence costs as well as financial damages and compensation. Depending on local legal, tort and health care delivery systems, these costs may fall mainly to the insurance sector or on wider society.
The causes of multi-patient injuries
According to recent research by Willis Re, multi-patient injuries or deaths are not just confined to individual practitioners. Events involving multiple patients can arise from a variety of causes, with examples ranging from mis-calibrated radiotherapy or diagnostic devices; compounding and contamination errors for pharmaceutical or blood transfusion products; cost-constrained business practices in nursing and elder care homes; bodily implants such as PIP breast implants or hip replacements, which can have long-term side effects, and hospital-acquired superbugs and bacteria, to list just a few.
These examples may be variously described in insurance industry terminology as loss occurrences, serial, clash, batch or systemic losses, and they pose a real challenge to the insurance sector as well as to the health care community.
Working to minimize incidence and severity
In addition to providing the financial wherewithal to assist victims, regardless of whether the injuries arose from accidental, reckless or deliberate action, the insurance sector has a duty to protect health care providers from non-meritorious or malicious claims. While errors arising in the delivery of health care can never be entirely eliminated, the insurance and risk management sector works closely with health care professionals to reduce the incidence and severity of such events. Data on claims held by specialist liability insurers provide invaluable insights into causation and loss prevention, and can be actively deployed alongside best clinical practices such as peer-review to improve patient outcomes and reduce the likelihood of poor results.
Willis Re’s research sheds new light on some of the causes behind multi-patient losses, with the objective of making them more preventable and ultimately less costly. It also provides useful insights into the challenges that such large loss accumulations create for insurers, in particular for specialist medical liability insurers, many of which have limited risk diversification, geographic concentrations and tight constraints on capital. We will be highlighting some of our findings and exploring some of the implications for insurers and the wider health care community in an upcoming series of blogs.