Why Do Vascular Surgeons Get Sued? Analysis of Claims and Outcomes in Malpractice Litigation

Phair, John P.; Skripochnik, Edvard; Trestman, Eric B.; Lipsitz, Evan C.; Scher, Larry A.

doi:10.1016/j.jvs.2016.06.026

Cited by 3 publications

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“…2 Reviewing litigation series is therefore likely instructive in improving both systems failsafe mechanisms and provider awareness. 6,7 Given the paucity of studies of litigation involving hemodialysis access, we evaluated litigation related to hemodialysis access to understand the reasons for malpractice litigation in hemodialysis access cases and improve physician education.…”

Section: Jury Verdicts and Outcomes Of Malpractice Cases Involving Armentioning

confidence: 99%

Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access

et al. 2019

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Objective: To analyze malpractice cases involving hemodialysis access to prevent future litigation and improve physician education. Methods: Jury verdict reviews from the WESTLAW database from 1 January 2005 to 1 January 2015 were reviewed. The search terms “hemodialysis,” “dialysis,” “graft,” “fistula,” “AVG,” “AVF,” “arteriovenous,” “catheter,” “permacatheter,” and “shiley” were used to compile data on the demographics of the defendant, plaintiff, allegation, complication, and verdict. Results: Sixty-six cases involving the litigation pertaining to hemodialysis catheter, arteriovenous fistula (AVF) or arteriovenous grafts (AVGs) were obtained. Of these, 55% involved catheter-based hemodialysis access, 18% involved AVF, and 27% involved AVG. The most frequent physician defendants were vascular surgeons (36%), internists (14%), nephrologists (14%), general surgeons (9%), and interventional radiologists (6%). Of the patients, 38% involved were male and the average patient age was 56.3 (standard deviation (SD) = 20.1) years. Region of injury was 50% in the neck or chest, 42% in the arm, and 8% in the groin. Injury was listed as death in 79% of cases. Of the deaths, 95% involved bleeding at some point in the chain of events. The most common claims related to the cases were failure to perform the surgery or procedure safely (44%), failure to diagnose and treat in a timely manner (30%), and negligent hemodialysis treatment (11%). The most common complications cited were hemorrhage (62%), loss of function of limb (15%), and ischemia due to steal syndrome (11%). A total of 26 cases (39%) were found for the plaintiff or settled. The median award was US$463,000 with a mean of US$985,299 (SD = US$1,314,557). Conclusion: While popular opinion may indicate that steal syndrome is a commonly litigated complication, our data reveal that the most common injury litigated is death which may frequently be the result of a hemorrhagic episode. In addition to hemorrhage, the remaining most common complications included steal syndrome and loss of limb function. Therefore, steps to better prevent, diagnose and treat bleeding, nerve injury, and steal syndrome in a timely manner are critical to preventing hemodialysis-access-associated litigation.

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Section: Jury Verdicts and Outcomes Of Malpractice Cases Involving Armentioning

confidence: 99%

Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access

et al. 2019

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“…Furthermore, this study identifies potential predictors of case outcomes based on case characteristics. Standardized and transparent reporting of malpractice claims has the potential to significantly increase physician understanding of litigation in their specialty and open pathways to improve clinical outcomes and reduce medicolegal toll 39,40…”

Section: Discussionmentioning

confidence: 99%

Current Trends and Predictors of Case Outcomes for Malpractice in Colonoscopy in the United States

Patel

Kothari

Gantz

et al. 2020

Journal of Clinical Gastroenterology

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Background: Over 14 million colonoscopies are performed annually, and this procedure remains the largest contributor to malpractice claims against gastroenterologists. The aim of this study was to evaluate reasons for litigation and predictors of case outcomes.Materials and Methods: Cases related to colonoscopy were reviewed within the Westlaw legal database. Patient demographics, reasons for litigation, case payouts, and verdicts were assessed. Multivariate regression was used to determine predictors of defendant verdicts.Results: A total of 305 cases were included from years 1980 to 2017. Average patient age was 54.9 years (range, 4 to 93) and 52.8% of patients were female. Juries returned defendant and plaintiff verdicts in 51.8% and 25.2% of cases, respectively, and median payout was $995,000. Top reasons for litigation included delay in treatment (65.9%) and diagnosis (65.6%), procedural error (44.3%), and failure to refer (25.6%). Gastroenterologists were defendants in 71% of cases, followed by primary care (32.2%) and surgeons (14.8%). Cases citing informed consent predicted defendant verdict (odds ratio, 4.05; 95% confidence interval, 1.90-9.45) while medication error predicted plaintiff verdict (odds ratio, 0.18; 95% confidence interval, 0.04-0.59). Delay in diagnosis (P = 0.060) and failure to refer (P = 0.074) trended toward plaintiff verdict but did not reach significance. Most represented states were New York (21.0%), California (13.4%), Pennsylvania (13.1%), Massachusetts (12.5%).Conclusions: Malpractice related to colonoscopy remains a significant and has geographic variability. Errors related to sedation predicted plaintiff verdict and may represent a target to reduce litigation. Primary care physicians and surgeons were frequently cited codefendants, underscoring the significance of interdisciplinary care for colonoscopy.

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“…Prior investigations of malpractice claims and outcomes involving vascular surgeons reveal that the most common allegations include failure to diagnose or treat conditions or a delay in treatment. 1 Early work primarily suggested that good documentation and potentially specialist consultation may help prevent malpractice litigation although data were limited. 2 A more recent study in the United Kingdom found that surgical specialties were more prone to litigation in the setting of VTE.…”

Section: Introductionmentioning

confidence: 99%

Common Reasons for Malpractice Lawsuits Involving Pulmonary Embolism and Deep Vein Thrombosis

Wilson

Phair

Carnevale

et al. 2020

Journal of Surgical Research

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Why Do Vascular Surgeons Get Sued? Analysis of Claims and Outcomes in Malpractice Litigation

Cited by 3 publications

References 0 publications

Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access

Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access

Current Trends and Predictors of Case Outcomes for Malpractice in Colonoscopy in the United States

Common Reasons for Malpractice Lawsuits Involving Pulmonary Embolism and Deep Vein Thrombosis

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