Medical malpractice in spine surgery: a review

Medress, Zachary A.; Jin, Michael C.; Feng, Austin Y.; Varshneya, Kunal; Veeravagu, Anand

doi:10.3171/2020.8.focus20602

Cited by 31 publications

(18 citation statements)

References 50 publications

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Section: Discussionmentioning

confidence: 99%

“…10 Orthopedic spine specialists are under a similar litigation risk. 10 Given the potential association between complaints, risk, and malpractice events, it is imperative that spine surgeons understand the ways in which these complaints are generated. The two most common complaint domains in this study were access & availability and care & treatment, which is consistent with prior reports.…”

Section: E523mentioning

confidence: 99%

“…1 Neurosurgeons specializing in spine surgery are at even higher risk of litigation compared with neurosurgeons who do not specialize in spine. 10 Orthopedic spine specialists are under a similar litigation risk. 10 Given the potential association between complaints, risk, and malpractice events, it is imperative that spine surgeons understand the ways in which these complaints are generated.…”

Section: E523mentioning

confidence: 99%

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Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

Rae

Rocha

Hayes

et al. 2021

Spine

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Study Design. Case-control study. Objective. To analyze patient complaints, potential risk, and malpractice events involving orthopedic spine surgeons over a 10-year period. Summary of Background Data. Unsolicited patient complaints may be associated with risk management and malpractice events. Methods. We analyzed patient complaint, potential risk event, and malpractice event data for six orthopedic spine surgeons over a 10-year period. Patient complaints were analyzed and classified according to the Patient Complaint Analysis System. Baseline demographics were recorded for patients with complaints as well as the surgeons. A control group consisting of all patients seen by the six surgeons during the study period was created to identify patient and physician risk factors for formal patient complaints. Event rates (for complaints, risk, and malpractice events) were calculated by dividing the number of events by the total number of unique patients seen. Results. There were 214 complaint designations among 202 patients with formal complaints, resulting in a complaint rate of 0.79%. Patients were most likely to complain about access and availability (35%) followed by care and treatment (32%). Of the 68 complaints regarding care and treatment, 34 were related to dissatisfaction with surgical outcome. Complications were identified in 26/34 cases. The malpractice event rate ranged from 0.06% to 0.65%. Patients who had surgery (P< 0.0001) or a mental, behavioral, or neurodevelopmental disorder (P = 0.0004) were more likely to file complaints compared with the control group. Conclusion. While infrequent, patient complaints against orthopedic spine surgeons are most related to access and availability. The rate of malpractice events varies widely between surgeons.

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Section: Discussionmentioning

confidence: 99%

Section: E523mentioning

confidence: 99%

Section: E523mentioning

confidence: 99%

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Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

Rae

Rocha

Hayes

et al. 2021

Spine

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“…Biochemical theory was formulated trying to explain both the delay of the onset of symptomatology and the atraumatic FES. It involves fat goblet properties such as endothelial toxicity of fatty acids released by the activation of lipase with induction and release of proinflammatory factors (like IL-1 and 6) and the prothrombotic activity of free circulating fat goblet which could cause platelets covering and the setting of coagulation cascade [1,9,11]. Elevated levels of plasma phospholipase A2, proinflammatory cytokines (TNF-alpha, IL-1, IL-6) have been observed in patients with fat embolism syndrome [12].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with spinal instability caused by different spine disorders (traumatic fractures, metastatic tumors, in-fections and degenerative conditions) often require spinal fusion surgery. Although spinal fusion surgery can be associated with serious complications, perioperative mortality is generally considered rare, with a death-rate of 0.13 [1,2]. Fat embolism syndrome (FES) is a clinical life-threatening condition characterized by neurological, respiratory, hematological and cutaneous manifestations.…”

Section: Introductionmentioning

confidence: 99%

Spine surgery and fat embolism syndrome. Defining the boundaries of medical accountability by hospital autopsy

Radaelli¹,

Zanon²,

Concato³

et al. 2021

Front. Biosci. (Landmark Ed)

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Background: Fat Embolism Syndrome (FES) is a clinical condition characterized by neurological, respiratory, hematological and cutaneous manifestations. Fatal FES has been described as a rare complication during or after spinal elective surgery. The investigation of the cause of death in fatalities related with spine surgery should be mandatory to exclude or confirm fat embolism; a detailed methodological approach to the body in these cases suggests to provide a cautious dissection of surgical site and collection of samples to detect embolized fat globules in vessels. Methods: Two fatal cases of fat embolism syndrome after posterior spinal fusion are presented. Conclusions: A complete post mortem examination by means of histochemical and immunohistochemical analysis explained the cause of death and prevented medical malpractice litigation. Fineschi V. CD61 and fibrinogen immunohistochemical study to improve the post-mortem diagnosis in a fat embolism syndrome clinically demonstrated by transesophageal echocardiography. Forensic Science International. 2010; 202: e13-e17.

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A spatial registration method based on 2D–3D registration for an augmented reality spinal surgery navigation system

Zhang,

Yang,

Jiang

et al. 2023

Robotics Computer Surgery

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BackgroundIn order to provide accurate and reliable image guidance for augmented reality (AR) spinal surgery navigation, a spatial registration method has been proposed.MethodsIn the AR spinal surgery navigation system, grayscale‐based 2D/3D registration technology has been used to register preoperative computed tomography images with intraoperative X‐ray images to complete the spatial registration, and then the fusion of virtual image and real spine has been realised.ResultsIn the image registration experiment, the success rate of spine model registration was 90%. In the spinal model verification experiment, the surface registration error of the spinal model ranged from 0.361 to 0.612 mm, and the total average surface registration error was 0.501 mm.ConclusionThe spatial registration method based on 2D/3D registration technology can be used in AR spinal surgery navigation systems and is highly accurate and minimally invasive.

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Medical malpractice in spine surgery: a review

Cited by 31 publications

References 50 publications

Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

Spine surgery and fat embolism syndrome. Defining the boundaries of medical accountability by hospital autopsy

A spatial registration method based on 2D–3D registration for an augmented reality spinal surgery navigation system

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