Trauma Surgery Malpractice Risk

Stewart, Ronald M.; Johnston, Joe; Geoghegan, Kathy; Anthony, Tiffany; Myers, John G.; Dent, Daniel L.; Corneille, Michael G.; Danielson, Daren; Root, Harlan D; Pruitt, Basil A.; Cohn, Stephen M.

doi:10.1097/01.sla.0000164179.48276.45

Cited by 38 publications

(7 citation statements)

References 15 publications

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“…The orthopedic claim data presented here derive mainly from intraoperative adverse events and mainly focus on elective orthopedic surgery. Traumatology accounts for only 25% of the claims, in good agreement with the findings of previous studies [ 7 ], possibly because of lower preoperative expectations of acute and hyperacute patients [ 16 ]. Indeed, it is believed that the most important reason for malpractice claims is a large negative disparity between the preoperative expectations of the patient and the postoperative results for that patient [ 7 , 17 ].…”

Section: Discussionsupporting

confidence: 90%

Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims

et al. 2018

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BackgroundMedical malpractice is an important topic worldwide, and orthopedics is a clinical branch that is considered to be at a high risk for claims. The analysis of a series of medmal insurance claims allows forensic pathologists, clinicians, and insurance companies to probe the risk of a specific clinical branch for medical malpractice claims and highlights areas where care may be improved. We investigated the main features of a major Italian insurance broker’s archive in order to identify recurrent pitfalls in this field.Materials and methodsA retrospective study was carried out on orthopedics claims. The archive covered claims from 2002 to 2013 that targeted 1980 orthopedists.Results635 claims were found and analyzed with a focus on the clinical activity invocked in the claim, the presence of alleged team malpractice, the clinical outcome of the case, and the final forensic decision regarding the claim. 299 orthopedists had at least one malpractice claim made against them during the available period; 146 orthopedists were subject to more than one malpractice claim. Most of the claims regarded perioperative and operative cases, usually originating from civil litigation. The anatomical sites most commonly involved were the hip or knees, and sciatic nerve lesions were the main contributor.ConclusionsOrthopedics is a medical specialty with a high risk for malpractice claims. In our study, medical malpractice was observed in nearly 50% of the cases—typically in surgery-linked cases resulting in permanent impairment of the patient. Death from orthopedics malpractice seemed to be rare.Level of EvidenceIV.

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Section: Discussionsupporting

confidence: 90%

Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims

et al. 2018

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“…In a review of three prospectively maintained databases comparing elective, urgent, and emergent cases in a general surgery practice, Stewart noted similar rates of claims filed per procedure performed for each surgical classification. 15 In a review of cases filed against one physician owned malpractice carrier in New York, Rovit et al 3 found that only 5% of spine cases arose from traumatic injuries. However, Agarwal et al 10 noted that claims arising after trauma represented 31.4% of cases in his review.…”

Section: Resultsmentioning

confidence: 99%

“… Mean indemnity payments for cases concluding in plaintiff’s verdict or settlement. 6 , 7 , 9 , 12 , 15 , 33 …”

Section: Resultsmentioning

confidence: 99%

Medical Malpractice Claims and Mitigation Strategies Following Spine Surgery

Jackson

Rumley

Griffith

et al. 2020

Global Spine Journal

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Study Design: Narrative review. Objective: The aim of this narrative review is to examine trends in malpractice litigation arising from spine surgery. We also hope to detail mitigation strategies that surgeons can employ to decrease their risk of a claim. Methods: A review of the relevant literature examining the prevalence, risks, and outcomes of malpractice litigation following spine surgery was conducted using the MEDLINE and Embase databases. Results: Combined queries identified 1140 potentially relevant articles. After eliminating duplicate articles and screening by title and abstract, 38 articles underwent full-text review. Of these, 22 were deemed relevant to the research questions posed. Evaluation of references identified 1 additional relevant article. Spine surgery represents one of the most litigious specialties in the United States health care system. The available literature points to a consistent pattern of common allegations leading to litigation following spine surgery. While a majority of filed lawsuits end in the surgeon’s favor, these cases carry high monetary and time expenditures regardless of outcome. Furthermore, the threat of a malpractice lawsuit motivates many surgeons to practice defensive medicine by utilizing unnecessary or unindicated tests and studies. Conclusion: Through the examination of trends in malpractice claims and case outcomes, surgeons may be able to adapt practices to minimize their risk of litigation. These changes can include, but are not limited to, identification of those procedures that are most litigious and a more thorough discussion of the informed consent process to include operative and nonoperative treatments prior to all procedures. More important, however, spine surgeons can potentially serve as advocates for change.

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“…Other authors have mentioned a misbalance in expectations before surgery and the result that follows [ 10 , 30 ]. This could very well explain the fact that most surgical claims are related to an elective procedure, since in acute setting expectations might be lower [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Claims in orthopedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis

Sanders

Wimmer-Boelhouwers

Dijt

et al. 2020

Eur J Orthop Surg Traumatol

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Background Orthopedic foot/ankle surgery is a high risk specialty when it comes to malpractice claims. This study aims to evaluate the incidence, characteristics and outcome of claims in this area. Methods This was a retrospective, 10-year claim analysis, with data from an anonymous database. Baseline claim/claimant characteristics were collected from all orthopedic foot/ankle-related cases. Results Of 460 claims in total, most were related to delay in/wrong diagnosis or to (complications of) elective surgical procedures. Whether a claim was settled was related to type of injury (fracture) and type of claim (diagnostic mistake). Median amount disbursed in settled claims was €12,549. Claim incidence did not increase over the years. Conclusion Missed fracture diagnosis and “failed”/disappointing results of elective surgical procedures were the most common causes for claims. Sufficient knowledge of missed (foot) fractures and clear communication/expectation management before elective procedures could help to improve quality of healthcare and patient satisfaction.

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Trauma Surgery Malpractice Risk

Abstract: These data demonstrate no increased risk of lawsuit when caring for trauma patients, and the actual risk of a malpractice lawsuit was low.

Cited by 38 publications

References 15 publications

Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims

Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims

Medical Malpractice Claims and Mitigation Strategies Following Spine Surgery

Claims in orthopedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis

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