May 10, 2020

The Doctors Company, the largest physician-owned medical malpractice insurance carrier in the United States, reviewed medical oncology claims that closed between 2012 and 2018. The March 2019 analysis found 101 medical oncology claims and two surgical oncology claims. The Doctors Company excluded the two surgical oncology claims because of the limited number of such claims.

Most Common Oncology Medical Malpractice Claims

The Doctors Company found that the seven most common injuries that prompted oncology medical malpractice claims were patient death (50%), metastasis (27%), adverse reactions (25%), undiagnosed malignancies (20%), reduced life expectancy (10%), emotional trauma (9%), and organ damage (7%). Because patients may suffer more than one injury, the percentages above total more than 100%.

The Doctors Company reported that 26% of medical oncology medical malpractice claims resulted in a payment to the patient or family members. Half of the payments for alleged medical oncology medical malpractice claims were less than $100,000 but three of such claims exceeded $1 million each (representing 13% of paid medical oncology medical malpractice claims).

The three primary bases for medical oncology medical malpractice claims were (1) failure or delay in diagnosis (29%) – the most common diagnoses were secondary malignant neoplasm of the bone and bone marrow, malignant neoplasm of the breast, and malignant neoplasm of the liver; (2) mismanagement of treatment (29%) – including inappropriate selection of treatment (including failure to order medications and ordering medications that were contraindicated or were not the most appropriate for the patient’s condition), patient behavior (such as failure to adhere to treatment or medication plans), inadequate communication between the patient or family and the provider (such as limited or nonexistent documentation regarding physicians’ conversations with patients about the consequences of refusing treatment or other options for the patient to consider); and, (3) medication management (13%) – most of the drugs associated with oncology claims were chemotherapy and immunosuppressants.

The Doctors Company acknowledged that “Medical errors can be devastating to oncology patients, who are often very ill and fragile” and recommends that oncologists employ the following strategies to help physicians reduce some of the risks revealed in its analysis:

– Complete a thorough assessment, and reevaluate if the patient’s condition changes. Inadequate assessments were the most frequent factor contributing to diagnosis-related oncology claims.

– Master your electronic health record. Another cause of claims was overlooking important clinical information in the electronic health record.

– Put an effective tracking system in place—one that can track consult reports and test results and help you know when to expect results and when a patient fails to have a test performed.

– Encourage open communication with patients. Open communication with the patient is essential for eliciting important information and encouraging candid revelations. It also seems to improve rates of adherence to treatment plans.

– Create an environment in which any member of the healthcare team can raise a concern. This increases the chance that errors will be identified and communicated before the patient suffers harm. The healthcare team is essential for catching inadvertent errors in medication orders and other medication-related treatment.


If you or a loved one may have been injured as a result of oncologist medical malpractice in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your oncology medical malpractice claim for you and represent you or your loved one in an oncologist medical malpractice case, if appropriate.

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