ProMutual Program Targets Baby Delivery Emergencies

July 28, 2004

ProMutual Group, the Boston-based provider of medical malpractice insurance in the Northeast, has launched a new patient safety program aimed at reducing the incidence of shoulder dystocia.

Shoulder dystocia is a birth condition in which a baby’s shoulder is blocked during delivery, and occurs in just one percent to four percent of deliveries. According to a review of ProMutual Group’s labor and delivery claims, “negligent management of shoulder dystocia” is now one of the most frequent and most costly allegations made against obstetricians and certified nurse midwives. The reason is that many shoulder dystocias result in Erb’s Palsy, fractures of the clavicle or humerus and even death. When permanent injury does occur, litigation is likely to ensue, according to the insurer.

There are certain factors that put a woman at increased risk for this complication; however, there is no way of precisely predicting this complication and a number of babies born to women with no risk factors will experience shoulder dystocia, ProMutual says. Thus, shoulder dystocia is an obstetric emergency in which the medical team has just a matter of minutes to execute various maneuvers to dislodge the impacted shoulder or to be ready to perform an emergency Cesarean delivery, if necessary.

According to ProMurtual, this emergency requires a plan and each member of the team must know exactly what his or her role is well beforehand. However, many claims that result from shoulder dystocia occur because of confusion due to inadequate planning and training.

Recognizing the need for training, Bay State Medical Health Systems developed a specialized shoulder dystocia patient safety program. Veritech Corporation used that content to create an interactive CD-ROM training course which defines the expectations for and roles of every person who may find him/herself involved in a shoulder dystocia delivery. This program has been endorsed by the Massachusetts Chapter of the American College of Obstetricians and Gynecologists (ACOG).

ProMutual Group has licensed this program. In a pilot project, every OB/GYN, Family Practitioner with OB privileges, or Certified Nurse Midwife insured by ProMutual in Massachusetts received the training CD beginning in June. Scoring of the course’s built-in test is done on-line by Veritech and the results are sent to ProMutual Group. Physicians who successfully complete the exam during a policy year will receive a credit at their next renewal.

ProMutual Group is also piloting the course with a hospital in Massachusetts. In this pilot, every delivery team member will take the course and the hospital will receive a credit upon renewal of their policy.

The insurer hopes that this course will improve patient safety and reduce medical malpractice claims. If it proves successful, the pilot program will may be expanded beyond Massachusetts.

ProMutual Group provides medical professional liability insurance coverage to nearly 16,000 physicians, surgeons and dentists as well as hundreds of hospitals, health centers and clinics. The companies operate in Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, Rhode Island and Vermont.

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