A nurse practitioner (“NP”) is a type of Advanced Practice Registered Nurse (“APRN”).  NPs are nurses with a graduate degree in advanced nursing.  NPs are trained to diagnose illnesses, perform physical assessments, and prescribe medication (depending on state regulations) related to primary care and specialty services.  This level of clinical judgment unfortunately opens the door for the medical malpractice lawsuits.

The number of NPs in the U.S. has doubled from 2010 to 2017 and the U.S. Bureau of Labor Statistics projects the number of NPs will increase by 46% by 2030.[i]  NPs are one of the fastest-growing careers in healthcare due to physician shortages and the need for more primary care providers in rural areas.  The Association of American Medical Colleges has estimated that by 2030, we will be facing a physician shortage of approximately 40,000 to 100,000 doctors.[ii]  With this rapid growth, there has been a significant increase in medical malpractice claims against NPs.

A recent study by CNA Insurance and the Nurses Service Organization examined 232 professional liability insurance claims against NPs for claims closed between January 1, 2017 to December 31, 2021.[iii]  The study shows the average total incurred amount of a NP claim in 2022 was $332,137.  This is a sharp 10.5% increase compared to 2017.  Claims against neonatal and pediatric NPs were significantly higher in cost than claims against family and gerontology NPs.  However, claims against family NPs were most prevalent.  Majority of claims involve diagnosis,  treatment and care management, and medication errors. The injury alleged in over 45% of NP malpractice cases in 2022 was death, with the most common causes including infection/sepsis, cardiac arrest, and cancer.

Many experts believe medical malpractice claims against NPs are likely to increase due to the COVID-19 pandemic, because NPs were on the front lines providing vaccinations and treatment.  As NPs take on a larger presence in the healthcare industry, malpractice claims will continue to increase.

Here are some tips for nurse practitioners to avoid malpractice claims:

Know the law in your state.  State practice and licensure laws vary by state.  Some states allow NPs to diagnose, order and interpret diagnostic tests, and initiate and manage treatment—including prescribing medications and controlled substances.  Other states restrict the NPs practice or require career-long supervision. Moreover, the authority under which an NP is authorized to practice depends on where the NP is practicing. It is important to know the laws of your jurisdiction as well as licensing requirements.

Take time to communicate with patients.  Most patients do not understand the complexities of medical diagnoses or treatment. Patients are also more likely to disclose important information if they feel comfortable.  NPs should ask clarifying questions to obtain all necessary history and information.  It is important to listen to the patient’s concerns by providing clear answers and realistic expectations.

Document, document, document.   Documentation is a common issue in every type of medical malpractice case.  Proper documentation allows healthcare providers reach an accurate diagnosis and prepare the best treatment plan.  NPs should follow the applicable policies and protocols of the hospital or healthcare facility for documentation.

Do not hesitate to make a referral.   When a patient’s care requires a specialist or emergency treatment, do not delay in making a referral.  NPs should exercise good clinic judgment in serious or emergent situations.

Complete continuing education.  Each state requires mandatory continuing education credits to maintain a license.  It is important to complete these credits and stay up to standard practices for NPs.

For questions or more information, please contact a local medical malpractice attorney.


[i] Occupational Outlook Handbook: Nurse Anesthetist, Nurse Midwives, and Nurse Practitioners, U.S. Bureau of Labor Statistics (lasted updated Sept. 8, 2022) https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm#tab-6.

[ii] Research Shows Shortage of More than 100,000 Doctors by 2030, AAMC (Mar. 4, 2017), https://www.aamc.org/news-insights/research-shows-shortage-more-100000-doctors-2030.

[iii] Nurse Practitioner Professional Liability Exposure Claim Report: 5th Ed., CNA & NSO (July 2022),   https://www.nso.com/Learning/Artifacts/Claim-Reports/Nurse-Practitioner-Claim-Report-5th-Edition.