Texas: Malpractice Payment of $995,000 for Injury to a Female Child (2017)

In 2017, a medical malpractice insurance company made a payment on behalf of a physician (MD) in Texas for approximately* $995,000. Payment was made in response to a claim of medical malpractice claim involving an injury along the lines of quadriplegia, brain damage, or the need for lifelong care suffered by a female child under the age of 10. The nature of the claim is broadly described as: "anesthesia related." The payment report submitted by a medical malpractice payer described the allegations in the claim as "Failure to Monitor."

* The payment amount is approximate because the National Practitioner Data Bank codes payments as a range value. The report's description of $995,000 corresponds to a malpractice payment somewhere between $990,001 and $1,000,000.

Claim at a Glance

Year of Payment: 2017

Location: Texas

Allegation: Failure to Monitor

Act or Omission: 2015

Payment Range: Between $990,001 and $1,000,000

Nature of Claim: Anesthesia Related

Payer: Insurance Company - Primary Coverage

Type of Care: Inpatient

Reporter: A Medical Malpractice Payer

Claim Insights

With respect to any medical malpractice payment, there are three major components of any claim. First, there is the act or omission that gave rise to an injury and whether the provider departed from an accepted standard of practice. Second, there is the nature of the injury itself, which includes several factors like its severity, duration, the impact on the patient’s life, the age and general health of the patient, along with many other elements. Third, there needs to be a causal connection between the negligent act or omission by the provider and the injury itself. Even with a showing of negligence, a medical provider is not legally responsible for an outcome that was not caused by the negligence.

With this in mind, the Data Bank does have some information that can give context to the medical malpractice payments, including the patient’s age, gender, whether it was inpatient or outpatient care, the type of malpractice or medical mistake that was alleged, and the ultimate outcome to the patient.

The information has significant limitations, however, that everyone should keep in mind. For one thing, the information is usually self-reported by the healthcare provider and his or her representatives. When reviewing this information, you should consider whether the patient would have described his or her injury as “minor” or “temporary” or “emotional only.” Further, there are important aspects of any claim valuation that simply cannot work in a database. Flagrant negligence might be coded the same way as what could be described as a smaller error, and one would have no way of knowing from these data. But even with these limitations and even where some required information is missing from any particular report, each of the payment reports in the database have enough to provide some insightful information that can help evaluate medical malpractice claims going forward.

Provider History Includes Five Licensure Reports

A medical provider's malpractice history can be extremely insightful. A long history of malpractice claims and discipline can certainly affect whether a matter is resolved and for how much. One of the most important goals of the National Practitioner Data Bank is to track providers' disciplinary and malpractice payment history throughout interstate moves or new employment situations.

In addition to this particular malpractice payment, this provider has three other types of reports on record that are worth noting. First, the database reflects that this particular provider had five licensure report(s) on record. These are more unusual among the providers for whom malpractice payments are recorded in the database - only about 15% of the providers with malpractice payments also have at least one licensure report as well.

Second, this provider has a DEA report on record. There are a number of reasons why the DEA would take action against a provider, including prescription practices or requiring oversight with controlled substances. There are only 69 payment reports (.03%) in the entire database associated with any provider with even one such report on record.

Third, this provider has three exclusion reports on record. The Office of the Inspector General keeps a database on providers who are excluded from Medicare, Medicaid, and other federal programs. The provider in this matter has such a report associated with them in the database.

Provider Detail

Alerts 10

Texas

Physician (MD)

Age: Between 30 and 40 Years Old in 2015 When Allegations Arose

Education Completed: Between 2000 and 2010

Malpractice Payments 1
This is the only payment in the database for this provider.
Licensure Reports 5
Adverse actions by the state licensing board are reported to the NPDB. Some of these actions are public, but some are not. All adverse actions must be reported in this database, whether or not they are public.
DEA Reports 1
These reports are submitted when the Drug Enforcement Administration takes action based on controlled substance registration.
Exclusion Reports 3
This report means a temporary or permanent barring from participation in a federal or state health-related program, e.g. Medicare and Medicaid, such that those entities will not reimburse the provider for services.
Payments

Similar Claims

Here are other claims involving an allegation of Failure to Monitor and an outcome of an injury along the lines of quadriplegia, brain damage, or the need for lifelong care suffered by a child under the age of 10 years old.
YearStateAmountAllegation
2021New York$1,150,000Failure to Monitor
2018Arizona$995,000Failure to Monitor
2017Texas$995,000Failure to Monitor
2015New York$745,000Failure to Monitor
2015Illinois$995,000Failure to Monitor
2014Georgia$255,000Failure to Monitor
2013Alabama$245,000Failure to Monitor
2012Ohio$345,000Failure to Monitor
2009Ohio$2,250,000Failure to Monitor
2009Alabama$2,250,000Failure to Monitor