| Cardiac Catheterization / PCI / Stenting |
Vascular access site injuries, coronary perforation, tamponade, stroke, and stent thrombosis. The defining procedure of interventional cardiology and a leading source of claims. |
Major premium driver; moves from diagnostic into interventional pricing tier ($18K–$40K+). |
| Electrophysiology / Ablation |
Cardiac perforation, phrenic nerve damage, pulmonary vein stenosis, and stroke during catheter ablation. Device lead complications add long-term exposure. |
Premium comparable to interventional cardiology ($20K–$45K); carriers evaluate procedure volume and complication rates. |
| Pacemaker / ICD Implantation |
Lead dislodgement, perforation, infection, device malfunction, and inappropriate shocks. Lead extraction is among the highest-risk EP procedures. |
Significant surcharge within EP tier; lead extraction adds substantial premium. |
| Failure to Diagnose MI / ACS |
Missed heart attacks and unrecognized acute coronary syndrome are among the most common and highest-severity cardiology claims. Delays in treatment can be fatal. |
High-frequency claim type across all cardiology subspecialties; carriers evaluate diagnostic protocols and documentation practices. |
| Anticoagulant Management |
Warfarin, DOACs, and heparin require careful monitoring. Over-anticoagulation causes hemorrhage; under-anticoagulation causes stroke or PE. |
Moderate premium factor; carriers evaluate INR monitoring protocols and patient education documentation. |
| Structural Heart Interventions (TAVR, MitraClip) |
Emerging high-acuity procedures with stroke, vascular injury, paravalvular leak, and mortality risk. Limited long-term outcome data. |
Growing risk area; may require specific endorsement. Carriers evaluate case volume and institutional outcomes. |
| Remote Monitoring / Wearable Interpretation |
Delayed review of Holter, event monitor, or continuous telemetry data can result in missed arrhythmias, cardiac arrest, or stroke. |
Emerging liability area; carriers evaluate turnaround protocols and alert response documentation. |
| Cardiothoracic Surgery |
CABG, valve repair/replacement, and transplant carry the highest mortality and complication rates in cardiology. Post-op hemorrhage, stroke, and infection are common claim triggers. |
Highest-cost cardiology tier ($50K–$100K+); separate surgical malpractice classification. |