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Medical Professional Liability Claims Associated With Stress Testing
Quick Takes
- Cardiologists ordering, supervising, and interpreting noninvasive stress testing [NIST] should follow consensus guidelines.
- Furthermore, they should evaluate patients before NIST, determine whether NIST is indicated and which modality is suitable, inform patients and appropriately supervise NIST, establish escalation protocols, and properly interpret, communicate, and follow results.
- Finally, cardiologists supervising NIST should observe both absolute and relative indications for cessation of testing.
Study Questions:
What are the factors that can reduce medical professional liability claims associated with noninvasive stress testing [NIST]?
Methods:
The investigators reviewed clinical summaries of deidentified 2007 to 2023 closed claims from a large, physician-owned national medical professional liability insurer. A claim reflects an allegation of cardiologist medical professional liability coupled with request for compensation; closed claims signify those withdrawn, denied, dismissed, settled, or litigated. Deidentified claim summaries did not include dates, geographic data, or identifying information, and the analysis was considered a quality inquiry, both exempted from Institutional Review Board reviews.
Results:
There were 14 NIST-related claims (2.7% of 524 total closed claims), arising during 25,567 cardiologist-years of coverage. NIST-related claims primarily involved allegations about treadmill injuries (n = 7), adenosine (n = 3), or follow-up and management (n = 4). Most claimants were in their seventh decade; 6 of the 14 harms included death and 6 were orthopedic injuries. The disposition of 7 of 14 claims was in favor of insured cardiologists.
Conclusions:
The authors report that cardiologists ordering, supervising, and interpreting NIST should follow consensus guidelines.
Perspective:
These data from medical professional liability claims help inform quality improvement in contemporary NIST practice. Cardiologists ordering, supervising, and interpreting NIST should follow consensus guidelines. Furthermore, they should evaluate patients before NIST, determine whether NIST is indicated and which modality is suitable, inform patients and appropriately supervise NIST, establish escalation protocols, and properly interpret, communicate, and follow results. Finally, cardiologists supervising NIST should observe both absolute and relative indications for cessation of testing.
Clinical Topics: Noninvasive Imaging
Keywords: Exercise Test, Liability, Legal
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