Cardiology's High-Stakes Risks: Data from Malpractice Claims Reveals Path to Safer Care

NAPA, CA – February 03, 2026 – The Doctors Company, the nation's largest physician-owned medical malpractice insurer, today released a detailed analysis that shines a stark light on the most significant sources of patient harm and professional liability within cardiology. The report, titled "Cardiology Claims: February Malpractice Risk Review," leverages thousands of real-world claims to identify patterns in diagnostic errors, treatment mishaps, and communication breakdowns that can lead to devastating patient outcomes and costly litigation.

This review is the latest installment in a year-long series for 2026, where the insurer dissects malpractice trends across different medical specialties each month. By transforming claims data into a preventative tool, the initiative aims to provide clinicians and healthcare leaders with the evidence-based insights needed to bolster patient safety and mitigate risk.

"Malpractice claims provide a powerful lens into how and why patient harm occurs," said Daniel Kent Cassavar, MD, MBA, FACC, Medical Director of The Doctors Company and a practicing cardiologist, in the company's announcement. "By analyzing cardiology claims, we can identify patterns that are not always visible in day-to-day practice. These insights help clinicians strengthen communication, refine clinical decision making, and improve care processes to support safer care for every patient."

The Heart of the Matter: Dissecting Cardiology's Top Risks

Cardiology has long been recognized as a high-stakes field with a greater-than-average risk for malpractice lawsuits. The new report from The Doctors Company reinforces this reality, identifying clinical judgment, communication, and documentation as the primary contributing factors to patient harm. The analysis goes beyond broad categories, however, providing specific examples and trends.

Diagnostic errors remain a leading cause of claims against cardiologists, accounting for roughly a quarter of all cases. These are not only frequent but are also often the most severe and costly, with studies showing that patients affected by a diagnostic error are twice as likely to die. A commonly missed diagnosis cited in malpractice literature is myocardial infarction (MI), where delays can have catastrophic consequences.

The report also highlights risks associated with specific procedures. A featured case summary delves into the failure to diagnose an atrial-esophageal fistula following a radiofrequency ablation—a known but rare complication that can be fatal if not identified and treated promptly. This detailed scenario underscores the need for heightened vigilance and a broad differential diagnosis in post-procedural patient care.

Beyond diagnosis and procedures, the report points to issues in the ongoing management of patients. These claims, which constitute a significant portion of litigation, can stem from poor medication management, failure to order appropriate tests, or breakdowns in communication and care coordination among the healthcare team. In a field where patients often have complex, chronic conditions, these management aspects are critical to both patient outcomes and risk reduction.

From Reactive Payouts to Proactive Prevention

The release of the cardiology review signals a broader evolution within the medical liability industry. Insurers like The Doctors Company are increasingly moving beyond their traditional role of financial risk transfer and claims payment. Instead, they are positioning themselves as data-driven partners in the quest for higher-quality, safer healthcare. By systematically analyzing their vast repositories of claims data, they can uncover systemic vulnerabilities and develop targeted educational resources.

This proactive approach is more critical than ever. The healthcare landscape is currently navigating a perfect storm of staffing shortages, rising patient acuity, and significant financial pressures. Furthermore, the legal environment has seen a dramatic increase in the frequency and size of jury awards, with so-called "nuclear verdicts" exceeding $10 million, placing immense strain on providers and insurers alike. In this challenging climate, preventing patient harm is not just a moral imperative but also a financial and operational necessity. The monthly risk review series, which focused on otolaryngology in January, represents a strategic effort to arm clinicians with the specific knowledge they need to navigate these pressures safely.

A Physician-Led Perspective on Patient Safety

A key element that lends credibility and relevance to the report is the insurer's organizational structure. As a physician-owned and led company, The Doctors Company brings a unique perspective to its analysis. The insights are developed by physicians for physicians, fostering a sense of partnership rather than adversarial oversight. This model is built on the premise that those who practice medicine are best equipped to understand its complexities and identify meaningful opportunities for improvement.

This peer-to-peer approach is central to the company's mission to "advance, protecting, and rewarding the practice of good medicine." As part of TDC Group, which serves over 120,000 healthcare professionals and organizations, the insurer has access to a massive dataset that fuels its analyses. This scale allows for the identification of statistically significant trends that might be missed by smaller entities or individual hospital systems, providing a powerful, nationwide benchmark for safety and risk.

Actionable Insights for the Front Lines

Ultimately, the value of the "Cardiology Claims" review lies in its practical application. For practicing cardiologists, department heads, and hospital risk managers, the report is not an indictment but a roadmap for improvement. It reinforces the importance of fundamentals: clear and empathetic patient communication, meticulous documentation that tells the complete patient story, and a commitment to a rigorous and well-documented decision-making process.

Interestingly, research from The Doctors Company has previously shown that a large majority of claims do not actually result in a payment to the patient, suggesting that negligence was not proven. A 2014-2019 study found only 31% of diagnostic cardiology claims ended with an indemnity payment. While this is reassuring, the emotional, professional, and financial toll of defending a lawsuit is immense, regardless of the outcome. Therefore, the strategies outlined in the review—which focus on preventing the initial breakdown in care or communication that leads to a claim—are invaluable. By translating the painful lessons of past malpractice claims into forward-looking safety protocols, the healthcare industry can better protect its most valuable assets: its patients and its providers.