Avoiding Liability Bulletin – March 1, 2017
Nurses are concerned about their potential liability for patient care and advanced practice registered nurses (APRNs) are no exception. As you know, APRNs’ scope of practice is quite different from RNs. APRNs’ scope of practice includes, among other responsibilities, advanced nursing assessment and evaluation, prescriptive authority, and delegating care to nurse colleagues and others. Many, including APRNs, wonder if their advanced role results in lawsuits alleging professional negligence and, if so, what is the data concerning these lawsuits?
One group of APRNs is the Nurse Practitioner (NP). The American Association of Nurse Practitioners Fact Sheet indicates there are more than 222,000 NP licensed in the US.1 However, their malpractice rate remains low: only 1.9% of the 222,000 NPs have been named as a “primary defendant” in a malpractice case.2
This is an interesting figure, since a study analyzing malpractice claims between 1991-2007 that were reported to the National Practitioner Data Bank showed that 37% of physicians and 3.1% of Physician Assistants (PAs) were required to pay damages for malpractice claims filed by patients while only 1.5% of NPs had to pay damages during the same period.3 It appears that the rate for NPs paying damages from 2007 to 2016 rose only 0.6 %.
Another study conducted by a “large medical malpractice insurance company” of adverse incidents and claims involving NPs between January of 2007, and December 31, 2011, totaled 1800. Of those 1800, 200 were analyzed because the amount paid by the insurance company due to a judgment against the NP was in excess of $10,000.00.4
The study determined that the average payment for the 200 closed claims was $221,852.00, an increase of 19% for average payments made from a prior 10 year period. 96% of the NPs for whom payments were made to the plaintiff in excess of $10,000.00 had individual policies (as opposed to policies issued to a medical practice or clinic.)5
Another published source specifies that the most common allegations against NPs in its study were failure to diagnosis, failure to diagnose in a timely fashion, failure to treat, and medication errors.6
Many reports, studies and statistics exist about APRNs and NPs specifically in relation to professional negligence claims. They need to be carefully analyzed to ensure their accuracy and need to be compared and contrasted in such areas of sample size, year the study took place, amounts of payments made to injured plaintiffs, and other factors.
Even so, it seems that NPs have less suits filed against them for professional negligence than their physician and PA counterparts. This may change as NPs continue to be utilized in increasing numbers in health care delivery.
Remember, too, that these studies reflect payments made out on behalf of the NP. Many more NPs and APRNs may have been sued during all the time frames listed above, and including currently, but those lawsuits did not result in a verdict and a payment against the NP.7
Despite the brevity and the incomplete discussion of these, and other, study numbers and descriptions, implications do exist for you as an NP. They include:
- Become an active member of your professional nursing associations (i.e, American Association of Nurse Practitioners, American Association of Nurse Anesthetists);
- Purchase your own professional liability insurance policy so that if a judgment is entered against you, you have the amount of the policy behind you AND a lawyer who represents YOU;
- Stay current in your area of specialty;
- Continue your education with an advanced degree, certification, and other credentialing;
- Remember to spend time with your clients and remain patient-focused; and
- Always function within the scope of your practice as defined by your state nurse practice act and its rules.
You can read more of the reports cited above by going to the website or links listed below.
- American Association of Nurse Practitioners (2016), “NP Fact Sheet”, at https://www.aanp.org/all-about-nps/np-fact-sheet.
- J. Ulman (2015), “How Often Are Nurse Practitioner Sued?” at nurse-practitioners-and-physician-assistants.advanceweb.com/Columns/Legal-Issues?How-often-are-nurse-practitioenrs-sued.aspx.
- “Nurse Practitioner Malpractice Statistics” (n.d.), at https://www.medicalmalpracticelawyers.com/blog/nurse-practitioner-malpractice/ .
- Ibid, at 3.
THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK SUCH ADVICE FROM A COMPETENT PROFESSIONAL.