The survey, which is the seventh liability survey of ob-gyns that has been conducted for the ACOG since 1983, looked at claims against ob-gyns from 1996 to 1998. It was based on self-administered mail questionnaires completed by a representative sample of 1,428 ACOG member physicians who live in the 50 states, District of Columbia and Puerto Rico. The sample is weighted to be representative of the population of board-certified ACOG physicians in these locations.

The report showed that for ob-gyns, obstetric malpractice claims (58.6 percent) occurred more often than gynecologic claims (38.2 percent). Obstetric claims continued to result in higher damage awards, with an average payment of $459,324. While claims involving allegations of gynecologic malpractice had an average award of $190,364.

In regards to settlements, the report showed that more than half of all ob-gyn claims (53.9%) were either dropped or settled without payment. Ob-gyns also won 65.5 percent of all claims resolved by arbitration, jury or court verdict.

The ob-gyns that were surveyed reported making changes in their practices as a result of the risk of malpractice. But, more ob-gyns reported making changes in obstetric practices (26.1 percent) than in their gynecologic practice (9.6 percent). The changes that the doctors made in obstetric practices included decreasing the level of high-risk obstetric care; no longer practicing obstetrics; and decreasing the number of deliveries. The changes in gynecologic practices included decreasing gynecologic surgical procedures performed; and no longer doing major gynecologic surgery.

The report also found that the primary allegation for obstetric claims was a "neurologically impaired infant." This also was the primary allegation in the 1996 survey. The second most frequent primary allegation in the 1999 survey was "stillbirth/neonatal death."

The primary allegation for gynecologic claims in the 1999 survey was "patient injury, major," which went up slightly to 25.8 percent from the 1996 survey, which was 25.2 percent. The second most frequent primary allegation in 1999 was "failure to diagnose." The "failure to diagnose" cases included failure to diagnose breast, cervical and ovarian cancer.

The survey also found that in 1998, the national average paid for an annual professional liability premium was $29,186. However, ob-gyns in two states paid significantly higher premiums. Florida premiums averaged $35,233 and New York averaged $53,225.

"The purpose of the survey is to discern the impact professional liability is having on the practice of obstetrics and gynecology," said ACOG staff attorney Susannah Frazier, JD. "It also provides trend data on practice patterns as well as liability insurance costs and level of coverage."