Product and Equipment Coding in National Practitioner Data Bank Malpractice Payment Reports, 2019-2025
TL;DR
Physician malpractice payment reports containing product or equipment codes were rare and had lower coded injury severity and payment values than other physician reports, and the codes should not be used alone to define or estimate the malpractice burden associated with medical products.
Abstract
Introduction: Codes related to products and equipment in the National Practitioner Data Bank (NPDB) may identify only a selected subset of malpractice payment reports involving medical products. Our objective was to compare coded injury severity and payment profiles between physician malpractice payment reports with and without product or equipment coding, and to determine whether any differences reflected allegation-group composition, so that researchers can judge whether these codes are usable as a standalone case definition for product-related malpractice. Methods: We conducted a retrospective cross-sectional analysis of United States physician malpractice payment reports in the NPDB Public Use File with report origination years from 2019 through 2025, the seven most recent complete origination years in the file. Product or equipment coding was identified from the allegation group and allegation code fields. Payments are released in the Public Use File as categorical bands representing the payment made by the payer for the named practitioner; each band was represented by its midpoint. We compared coded injury severity and banded payment distributions and estimated associations with severe injury or death before and after adjustment for allegation group. Results: Among 54,351 reports, 589 (1.08%) had product or equipment coding. Severe injury or death was coded in 77 product/equipment-coded reports (13.1%) and 26,467 non-product/equipment-coded reports (49.2%); death was coded in 40 product/equipment-coded reports (6.8%) and 17,240 non-product/equipment-coded reports (32.1%). Median payment-band midpoint values were $97,500 for product/equipment-coded reports and $265,000 for non-product/equipment-coded reports. The association between product or equipment coding and lower odds of coded severe injury or death persisted after adjustment for allegation group (adjusted odds ratio, 0.29; 95% confidence interval, 0.21-0.40). Conclusions: Physician malpractice payment reports containing product or equipment codes were rare and had lower coded injury severity and payment values than other physician reports. These findings describe how claims are coded rather than how severely patients were injured, and the codes should not be used alone to define or estimate the malpractice burden associated with medical products.