1635. Analysis of Antibiotic-Related Malpractice Claims, 2007 to 2016

BACKGROUND: The threat of medical liability can influence physician behavior and lead to the practice of “defensive medicine.” Concern for malpractice liability has been cited as a cause of inappropriate antibiotic prescribing. Data on malpractice claims related to antibiotic use (AU) are lacking. The objectives of this analysis were to describe malpractice claims associated with AU. METHODS: We conducted a retrospective analysis of pooled closed antibiotic-related claims from a malpractice carrier representing 30% of US malpractice cases from January, 2007 to December, 2016. We described antibiotic-related, malpractice claims, patient demographics, amount of indemnity paid, clinical severity, settings, responsible services, initial diagnoses, drug classes, and causes of allegation. RESULTS: From 2007 to 2016, 767 antibiotic-related claims were identified and represented less than 1% of overall claims. A total of $123 million were paid for antibiotic-related claims. Claims classified as medium to high clinical severity constituted 97% of all claims, with 35% having permanent injury and 24% leading to death. Of all patients, 56% were female, 8% were < 20 years of age, and 32% were ≥ 60 years old. Most claims (51%) were associated with outpatient settings, 37% with inpatient, and 11% with emergency department settings. Responsible services with the highest number of claims were medicine (44%), surgery (27%) and the emergency medicine (9%). The most common infection cited as an initial diagnosis was respiratory (10%), followed by urinary (7%) and skin and soft-tissue infections (6%). The most common class cited was β-lactams (19%), followed by fluoroquinolones (14%) and sulfa-drugs (11%). Allegations associated with antibiotic administration and management constituted 62% of all claims, 19% were related to failure or delay in diagnosis or treatment, and 19% were due to other causes. CONCLUSION: Claims related to AU were not a common cause of malpractice claims in these data source. Antibiotic administration and management was more commonly associated with malpractice claims than failure or delay in AU. A better understanding of malpractice claims associated with AU can help guide messaging on improving antibiotic prescribing. DISCLOSURES: All authors: No reported disclosures.