A Look at Opioid-Related Closed Claims and Lawsuits

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In the late 1990s and early 2000s, there was widespread concern regarding the underassessment and under treatment of pain and the subsequent designation of pain as the fifth vital sign.¹ In response, opioid prescribing patterns were modified leading, in part, to the current national alarm regarding large increases in abuse, drug dependence and overdose. More than fifty people die of opioid overdoses each day in the United States prompting the CDC to call it an epidemic of opioid overdoses.²

From 2006 to 2015, sixteen percent of MICA’s medication related closed claims involved opioid prescribing. Twenty-nine percent of MICA’s opioid-related claims were closed with an indemnity payment. In addition, seventy-one percent of the opioid-related claims at MICA were associated with a patient fatality. Average defense costs at MICA increased seventy percent when comparing the closed claims reported from 2006 through 2010 to 2011 through 2015. MICA experienced a thirty-eight percent decrease in the average indemnity from 2006 through 2010 to 2011 through 2015.

In light of the opioid epidemic, MICA has developed pain management resources for their insured physicians and advanced healthcare professionals. These include a Pain Management Self-Assessment Tool and a companion publication, Physician Practice Pain Management Toolkit. These aid physicians in mitigating their risk of liability while enhancing patent safety. The Tool provides a mechanism for member physician practices to review their current operational processes for providing pain management to their patents. The Toolkit oﬀers suggestions, resources, and checklists for those member physicians providing a pain management program.

Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000; 284(4):428-9.
Dowell D, Haegerich T, Chou R. CDC Guideline for prescribing opioids for chronic pain — United States, 2016. Recommendations and reports. 2016 March 18. Available from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

For more information regarding programs and services available to MICA members, or to become a MICA policyholder, contact Sarah Storms at 602.808.2135 or sstorms@mica-insurance.com.