Medical Malpractice in Nerve Injury of the Upper Extremity

Abstract

Background: Medical malpractice accounts for more than $55 billion of annual health care costs. Updated malpractice risk to surgeons and physicians related to upper extremity peripheral nerve injury has not been published. Methods: A comprehensive database analysis of upper extremity nerve injury claims between 1995 and 2014 in the United States was conducted using the Medical Professional Liability Association Data Sharing Project, representing 24 major insurance companies. Results: Nerve injury in the upper extremity accounted for 614 (0.3%) malpractice claims (total of 188 323). Common presenting diagnoses included carpal tunnel syndrome (41%), upper extremity fractures (19%), and traumatic nerve injuries to the shoulder or upper limb (8%). Improper performance (49% of total claims) and claims without evidence of medical error (19%) were the most common malpractice suits. Orthopedic surgeons were the most frequently targeted specialists (42%). In all, 65% of nerve injury claims originated from operative procedures in a hospital, 59% of claims were dismissed or withdrawn prior to trial, and 30% resulted in settlements. Thirty-three percent of claims resulted in an indemnity payment to an injured party, with an average payout of $203 592 per successful suit. Only 8% of claims resulted in a completed trial and verdict, and verdicts were overwhelmingly in favor of the defendant (83%). Conclusions: Most malpractice claims from peripheral nerve injuries in the United States arise from the management of common diagnoses, occur in the operating room, and allege improper performance. Strategies to reduce malpractice risk should emphasize the management of common conditions and patient-physician communication.

Litigation involving patients with slipped capital femoral epiphysis

“…Most studies of malpractice litigation in orthopedic surgery have used only one database: Westlaw, [12][13][14][15][18][19][20]24,29 VerdictSearch, 11,21 or the Medical Liability Association Data Sharing Project. 16 In this study we used several legal case databases, including the Westlaw, VerdictSearch®, MoreLaw, Lexis Jury Verdict, Nexis Uni®, and Google Scholar, allowing us to find as many reported cases as possible.…”

“…When health care providers think of litigation, it is often in the context of professional liability, also known as medical malpractice. Orthopaedic surgeons are acutely aware of malpractice litigation, [10][11][12][13][14][15][16][17][18][19][20][21] experiencing a 14% annual rate of litigation compared to the overall US national physician rate of 7%. 22 Other specialties involved in the care of children with SCFE include emergency medicine, diagnostic radiology, family practice, and pediatrics.…”

“…The 60% in this study of SCFE is clearly within these percentages. Regarding monetary payouts, the average payout ranged, in million US$ from 0.204 for upper extremity nerve complaints 16 to 3.778 for traumatic fracture complaints. 11 The average SCFE payout of $1.497 million in this study falls within these ranges.…”

Increasing Awareness of Complications of Nerve Injury Following Shoulder Surgery: Preventing Delays in Referral and Treatment

“…Patients should be appraised that given the nearby location of the critical nerves, coupled with shoulder pathology, that may inhibit neural glide at baseline, they are at risk of complications that do not imply negligence. 36 Patients with specific risk factors such as prior surgery to the affected shoulder, 6,13 patients undergoing reverse shoulder arthroplasty, 30 and female sex warrant thorough discussion during their preoperative consent process and should be paid special attention during their postoperative period. 6 We believe that having both patient and surgeon anticipating these potential complications can lead to an increased rate of identification and early referral to a nerve surgeon.…”

Improving the Quality of Maternity Care: Learning From Malpractice

“…Obstetric medical malpractice brought a huge burden to healthcare systems. In the United States, payments for medical malpractice are registered as U.S. $55 to $60 billion of annual healthcare costs 8,14 . Unfortunately, access to such data is limited in China.…”