1
|
Burton LE, Navaratnam AV, Magowan DS, Machin JT, Briggs TWR, Hall AC. Litigation in pediatric otorhinolaryngology: Lessons in improving patient care. Int J Pediatr Otorhinolaryngol 2022; 162:111288. [PMID: 36067709 DOI: 10.1016/j.ijporl.2022.111288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE(S) Medico-legal claims involving children place a substantial financial burden on health services and have a profound emotional and psychological impact on clinicians. Our objective was to analyze both the common causes and cost of litigation in pediatric otorhinolaryngology. METHODS A retrospective review of all clinical negligence claims within pediatric otolaryngology (0-17 years inclusive) in NHS (National Health Service) England held by the clinical negligence service 'NHS Resolution between' 4/2013 and 4/2020. RESULTS There were 100 claims in pediatric otorhinolaryngology accounting for an estimated potential total cost of just under £49 million with an average of 14 claims per year. Over half (52%) of claims were related to an operation with cause codes "Operator Error/Intra-Op Problem", "Diathermy Injury" and "Failure to Warn - Consent" most cited. The most common operation cited in a claim was tonsillectomy with an average cost per claim of £47,084. There were 21 claims coded as either "failure to diagnose" or "failure to treat" in relation to cholesteatoma, with an average cost per claim of £61,086. CONCLUSION This is the largest study to date analyzing the reasons and potential cost of clinical negligence claims within pediatric otolaryngology. Many learning opportunities exist to reduce patient morbidity, mortality and improve the patient experience through litigation data analysis.
Collapse
Affiliation(s)
| | | | | | - John T Machin
- Getting It Right First Time Programme, NHS England & NHS Improvement, England, UK
| | - Tim W R Briggs
- Getting It Right First Time Programme, NHS England & NHS Improvement, England, UK
| | | |
Collapse
|
2
|
Ceremsak J, Miller LE, Gomez ED. A Review of Otolaryngology Malpractice Cases with Associated Court Proceedings from 2010 to 2019. Laryngoscope 2020; 131:E1081-E1085. [PMID: 33146898 DOI: 10.1002/lary.29232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report key characteristics of the landscape of malpractice litigation with associated court proceedings in otolaryngology over the previous decade. STUDY DESIGN Retrospective database review. METHODS The LexisNexis database was queried to identify otolaryngology-related malpractices cases that yielded court opinions, jury verdicts, and settlements from federal and state courts across the United States from 2010 to 2019. Cases settled outside of court were not identifiable. Provider subspecialty, procedures, error type, legal allegations, and case outcomes were recorded. Frequency of error type was compared between otolaryngology subspecialties using Fisher exact tests. RESULTS Ninety-four medical malpractice cases related to otolaryngology with evidence of court proceedings were identified for the period between 2010 and 2019. An otolaryngologist was named as the sole defendant in 39 cases (41%). Rhinology was the most frequently implicated subspecialty (28% of all cases), followed by head and neck surgery (17%) and facial plastics (7%). Improper surgical performance was cited in nearly half of the identified cases (49%), followed by failure to diagnose/refer/treat (32%). Outcome and liability data were available for 56 cases (60%). Of these 56 cases, 50 (89%) were ruled in favor of the defendant otolaryngologist. Of the cases ruled in favor of the plaintiff, the average indemnity was $4.24 M (range, $150,000 M-$10.25 M). Fisher exact tests demonstrated statistically significant differences in consent issues (P = .040), failure to diagnose/refer/treat (P = .024), and improper surgical performance (P = .026) between subspecialties. CONCLUSIONS In a limited, database-derived sample of medical malpractice cases involving otolaryngologists, trends in error type by subspecialty may warrant further investigation to identify specialty-wide and subspecialty-specific areas of practice improvement and education. LEVEL OF EVIDENCE N/A Laryngoscope, 131:E1081-E1085, 2021.
Collapse
Affiliation(s)
- John Ceremsak
- Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Lauren E Miller
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Ernest D Gomez
- Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A.,Division of Otolaryngology - Head and Neck Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A
| |
Collapse
|
3
|
Rich BS, Shelton K, Glick RD. Litigation involving pediatric surgical conditions. J Pediatr Surg 2020; 55:602-608. [PMID: 31575412 DOI: 10.1016/j.jpedsurg.2019.08.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Malpractice litigation among pediatric surgeons is a subject of concern and interest, but minimal factual data are known. Our goal was to investigate national litigation trends regarding pediatric surgical conditions. METHODS We queried WestlawNext database for malpractice cases involving pediatric (age ≤ 18) surgical conditions. Cases were included if they named a care provider or health center. We gathered data on diagnoses, procedures, care providers, allegations, location, and outcomes. RESULTS Our search revealed 4754 cases, and 170 met inclusion criteria. These ranged from 1965 to 2017 and represented 40 states. 110 cases involved a surgeon (41% pediatric surgeons). Appendicitis was the most common diagnosis identified. Cases frequently involved delayed/missed diagnoses or interventions (45.9%), technical concerns (35.9%), mortalities (26.5%), negligent perioperative care (23.6%), and informed consent concerns (4.7%). Technical complication was the most common allegation against surgeons (49.1%), and nonsurgeon cases typically involved a delayed/missed diagnosis (78.3%). 39% of cases resulted in favor of the defendant, 35% plaintiff, and 14% had a split verdict. CONCLUSION Litigation involving pediatric surgical conditions is diverse, but appendicitis and circumcision comprise almost a third of cases. A greater understanding of these trends can help steer efforts in quality and safety as well as guide improved communication with families. LEVEL OF EVIDENCE N/A.
Collapse
Affiliation(s)
- Barrie S Rich
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11375; Division of Pediatric Surgery, Cohen Children's Medical Center, New Hyde Park, NY.
| | - Kevin Shelton
- Maurice A. Deane School of Law at Hofstra University, Uniondale, NY
| | - Richard D Glick
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11375; Division of Pediatric Surgery, Cohen Children's Medical Center, New Hyde Park, NY
| |
Collapse
|
4
|
Ideker HC, Julakanti JS, Momin NA, Chaaban MR. Determination of legal responsibility in shared airway management between anesthesiology and otolaryngology. Head Neck 2019; 41:4181-4188. [PMID: 31502364 DOI: 10.1002/hed.25948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/13/2019] [Accepted: 08/21/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Malpractice litigation remains an important point of contention in the United States. Airway management often sees multidisciplinary teams of anesthesiologists and otolaryngologists. This report analyzes lawsuits affecting both teams in airway management. METHODS The Westlaw legal database (West Publishing Co., St. Paul, MN) was used to search for malpractice cases involving failed airway management, where both anesthesiology and otolaryngology were involved. RESULTS Among the 28 cases analyzed, otolaryngology and anesthesiology were most commonly sued together (46.4%). When sued together, defendants were less likely to win and average award amounts ($4, 558 716) were higher. These cases most commonly occurred in the operating room (78.6%), involved a difficult/improper intubation (39.3%), alleged a failure to follow standard of care (57%), and resulted in death (60.7%). CONCLUSION These cases primarily cited failure to follow standard of care and communication failures. Efforts should be directed toward multidisciplinary airway management protocols and effective communication.
Collapse
Affiliation(s)
- Henry C Ideker
- School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Jatin S Julakanti
- School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Nishat A Momin
- School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Mohamad R Chaaban
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
5
|
Rynecki ND, Coban D, Gantz O, Gupta R, Ayyaswami V, Prabhu AV, Ruskin J, Lin SS, Beebe KS. Medical Malpractice in Orthopedic Surgery: A Westlaw-Based Demographic Analysis. Orthopedics 2018; 41:e615-e620. [PMID: 29940053 DOI: 10.3928/01477447-20180621-06] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/22/2018] [Indexed: 02/03/2023]
Abstract
A recent study that evaluated the risk of facing a malpractice claim by physician specialty found that orthopedic surgeons were at a significantly greater risk of being sued than other medical specialists. To date, no studies have characterized trends in orthopedic surgery malpractice claims. The Westlaw legal database was used to locate state and federal jury verdicts and settlements related to medical malpractice and orthopedic surgery from 2010 to 2016. Eighty-one cases were analyzed. The mean age of the affected patients and/or plaintiffs was 53.4 years. Spine surgery (21 cases; 25.9%), knee surgery (17 cases; 21.0%), and hip surgery (11 cases; 13.6%) were litigated most often. Procedural error (71 cases; 87.7%) and negligence (58 cases; 71.6%) were the 2 most commonly cited reasons for litigation. The jury found in favor of the defendant in most (50 cases; 61.7%) of the cases. The mean plaintiff (17 cases; 21.0%) verdict payout was $3,015,872, and the mean settlement (13 cases; 16.0%) value was $1,570,833. Unnecessary surgery (odds ratio [OR], 12.29; 95% confidence interval [CI], 1.91-108.46; P=.040) and surgery resulting in death (OR, 26.26; 95% CI, 2.55-497.42; P=.040) were significant predictors of a verdict in favor of the plaintiff. Patient death (OR, 0.05; 95% CI, 0.01-0.38; P=.021) and male patient sex (OR, 0.26; 95% CI, 0.09-0.71; P=.033) were significant negative predictors of a verdict in favor of the defendant. The jury found in favor of the defendant orthopedic surgeon in most cases. Procedural error and/or negligence were cited most commonly by the plaintiffs as the bases for the claims. Verdicts in favor of the plaintiffs resulted in payouts nearly double those of settlements. [Orthopedics. 2018; 41(5):e615-e620.].
Collapse
|
6
|
Descriptive Analysis of State and Federal Spine Surgery Malpractice Litigation in the United States. Spine (Phila Pa 1976) 2018; 43:984-990. [PMID: 29215494 DOI: 10.1097/brs.0000000000002510] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective review. OBJECTIVE This study aimed to determine the factors associated with malpractice litigation in cases involving spine surgery in the United States. SUMMARY OF BACKGROUND DATA Medical malpractice is of substantial interest to the medical community due to concerns of increased health care costs and medical decision-making for the sole purpose of reducing legal liability. METHODS The Westlaw online legal database (Thomson Reuters, New York, NY) was searched for verdict and settlement reports pertaining to spine surgery from 2010 to 2015. Data were collected regarding type of procedure, patient age and gender, defendant specialty, outcome, award, alleged cause of malpractice, and factors involved in the plaintiff's decision to file. Initial search queried 187 cases, after which exclusion criteria were applied to eliminate duplicates and cases unrelated to spine surgery, yielding a total of 98 cases for analysis. RESULTS The verdict was in favor of the defendant in 62 cases (63.3%). Neurosurgeons and orthopedic surgeons were the most common defendants in 29 (17.3%) and 40 (23.8%) of the cases, respectively. A perceived lack of informed consent was noted as a factor in 24 (24.4%) of the cases. A failure to diagnose or a failure to treat was noted in 31 (31.6%) and 32 (32.7%) cases, respectively. Median payments for plaintiff verdicts were nearly double those of settlements ($2,525,000 vs. $1,300,000). A greater incidence of plaintiff verdicts was noted in cases in which a failure to treat (P < 0.05) was cited, a patient death occurred (P < 0.05), or an emergent surgery had been performed (P < 0.01). CONCLUSION Overall, physicians were not found liable in the majority of spine surgery malpractice cases queried. LEVEL OF EVIDENCE 4.
Collapse
|
7
|
Gupta A, Svider PF, Rayess H, Sheyn A, Folbe AJ, Eloy JA, Zuliani G, Carron MA. Pediatric rhinoplasty: A discussion of perioperative considerations and systematic review. Int J Pediatr Otorhinolaryngol 2017; 92:11-16. [PMID: 28012510 DOI: 10.1016/j.ijporl.2016.10.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Pediatric rhinoplasty has traditionally raised numerous concerns, including its impact on growth as well as the psychological sequelae of undergoing a potentially appearance-altering procedure. Our objective was to critically evaluate available individual patient data relevant to pediatric rhinoplasty, and further discuss perioperative considerations. METHODS A systematic review was conducted using PubMed/MEDLINE databases. Data extracted and analyzed from included studies included patient demographics, surgical indications, operative approaches, outcomes, complications, revision rates, and other clinical considerations. RESULTS Seven studies encompassing 253 patients were included, with age ranging from 7 months to 19 years. Two-thirds of patients were male. 41.7% reported antecedent trauma, and common overall surgical indications included "functional aesthetic" (24.5%) followed by cleft lip nasal deformity (15.8%). The majority (79.1%) underwent open approaches, and 71.1% of patients underwent concomitant septal intervention. The most frequently used grafting materials were septal cartilage (52.8%) and conchal cartilage (16.5%). Surgical outcomes were heterogeneous among these studies. Complication rates were only specified in 5 of the 7 studies and totaled 57 patients (39.6%). Aesthetic dissatisfaction (11.8%) and postoperative nasal obstruction (5.6%) were the most commonly reported complications. Revisions were performed in 13.5%. CONCLUSION Rhinoplasty is safe in the pediatric population, although revisions rates appear greater than those reported in adults. This study of 253 represents the largest pooled sample size to date; nonetheless, non-standardized outcome measures, minimal long-term followup data, and lack of discussion regarding psychological sequelae all contribute to the need for further high-quality studies evaluating this topic.
Collapse
Affiliation(s)
- Amar Gupta
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Peter F Svider
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hani Rayess
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Anthony Sheyn
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA; Division of Pediatric Otolaryngology, LeBonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adam J Folbe
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark, NJ, USA; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Giancarlo Zuliani
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Michael A Carron
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
8
|
Hanba C, Svider PF, Siegel B, Sheyn A, Shkoukani M, Lin HS, Raza SN. Pediatric Thyroidectomy. Otolaryngol Head Neck Surg 2016; 156:360-367. [PMID: 28145836 DOI: 10.1177/0194599816677527] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives/Hypothesis To evaluate hospital course and associated complications among pediatric patients undergoing thyroidectomy. Study Design and Setting Retrospective database review of the Kids' Inpatient Database (2009, 2012). Methods The Kids' Inpatient Database was evaluated for thyroidectomy patients for the years 2009 and 2012. Surgical procedure, patient demographics, length of stay, hospital charges (in US dollars), and surgical complications were evaluated. Results Of an estimated 1099 nationwide partial thyroidectomies and 1654 total thyroidectomies, females accounted for 73.5% and 79.1% of patients, respectively. Children <1 year of age had significantly longer hospital courses ( P < .0001), and patients 1 to 5 years of age had a significantly greater length of stay than individuals 6 to 20 years of age (7.8 vs 2.1 days, P < .001). The most common complications overall included hypocalcemia, respiratory complications, vocal cord paresis/paralysis, postoperative infection, and bleeding. Vocal cord paralysis was noted in 1.7% of pediatric thyroidectomy patients. The presence of these complications among total thyroidectomy patients significantly increased one's length of stay and hospital charges. A neck dissection was reported in 22.9% of malignant thyroidectomy patients. Conclusion Nearly 20% of children who underwent total thyroidectomy experienced postoperative hypocalcemia, positing a need for the development of postoperative calcium replacement algorithms to minimize the sequelae of hypocalcemia. A greater incidence of respiratory and infectious complications among younger patients (<6 years) suggests a need for closer monitoring, possibly encompassing routine postoperative intensive care unit utilization, in an attempt to minimize these sequelae.
Collapse
Affiliation(s)
- Curtis Hanba
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F Svider
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Bianca Siegel
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,2 Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan, USA
| | - Anthony Sheyn
- 3 Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,4 Department of Pediatric Otolaryngology, LeBonheur Children's Hospital, Memphis, Tennessee, USA
| | - Mahdi Shkoukani
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,5 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,5 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - S Naweed Raza
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,5 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| |
Collapse
|
9
|
Hanba C, Bobian M, Svider PF, Sheyn A, Siegel B, Lin HS, Raza SN. Perioperative considerations and complications in pediatric parathyroidectomy. Int J Pediatr Otorhinolaryngol 2016; 91:94-99. [PMID: 27863650 DOI: 10.1016/j.ijporl.2016.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/10/2016] [Accepted: 10/13/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate perioperative considerations and post-operative complications associated with parathyroidectomy in the pediatric population. METHODS The Kids' Inpatient Database 21 (KID) was searched for patients who underwent parathyroidectomy in 2009 and 2012. Patient demographics, hospital stay, associated charges, and post-operative adverse sequelae were evaluated in all patients and included patient comorbidity and additional procedure requirement analysis. RESULTS There were 182 patients extrapolating to 262 parathyroidectomies over the two years analyzed. Although a minority of patients were male (45.4%), these patients had greater rates of complications, length of stay, and hospital charges. Importantly, minorities and younger patients (≤15y) also had more complicated post-operative courses. The lengths of stay for patients experiencing post-operative altered mental status (18.7d), post-operative infection (15.5d), respiratory complications (19d), and cardiac complications (13d) were significantly increased compared to individuals without major complications (3.4d) (p < 0.001). Patients with pre-existing chronic kidney disease, dialysis-dependence, and bone sequelae (most commonly from hungry bone syndrome) also had significantly lengthier stays and greater associated costs. CONCLUSION Findings from this analysis can be included in a comprehensive pre-operative informed consent process between physicians and patients discussing perioperative considerations and potential complications of parathyroidectomy. Males, younger children, and patients with preexisting renal conditions experienced lengthier and more complicated hospital stays, suggesting the need for closer monitoring of these cohorts.
Collapse
Affiliation(s)
- Curtis Hanba
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Michael Bobian
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Peter F Svider
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Anthony Sheyn
- Department of Otolaryngology - University of Tennessee Health Science Center, Memphis, TN, USA; LeBonheur Children's Hospital, Department of Pediatric Otolaryngology, Memphis, TN, USA
| | - Bianca Siegel
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Children's Hospital of Michigan, Detroit Medical Center, Detroit, MI, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - S Naweed Raza
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| |
Collapse
|
10
|
Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States. Int J Pediatr Otorhinolaryngol 2016; 90:214-219. [PMID: 27729136 DOI: 10.1016/j.ijporl.2016.09.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/22/2016] [Accepted: 09/22/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. METHODS AND MATERIALS A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice. RESULTS Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058). CONCLUSIONS Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions.
Collapse
|
11
|
Hojjat H, Svider PF, Folbe AJ, Raza SN, Carron MA, Shkoukani MA, Merati AL, Mayerhoff RM. Cost-effectiveness of routine computed tomography in the evaluation of idiopathic unilateral vocal fold paralysis. Laryngoscope 2016; 127:440-444. [DOI: 10.1002/lary.26152] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 05/07/2016] [Accepted: 05/31/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Houmehr Hojjat
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Peter F. Svider
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Adam J. Folbe
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
- Department of Neurosurgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Syed N. Raza
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
| | - Michael A. Carron
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Surgical Service, Section of Otolaryngology; John D. Dingell VA Medical Center; Detroit Michigan U.S.A
| | - Mahdi A. Shkoukani
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
- Surgical Service, Section of Otolaryngology; John D. Dingell VA Medical Center; Detroit Michigan U.S.A
| | - Albert L. Merati
- Department of Otolaryngology-Head and Neck Surgery; University of Washington School of Medicine; Seattle Washington U.S.A
| | - Ross M. Mayerhoff
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
- Surgical Service, Section of Otolaryngology; John D. Dingell VA Medical Center; Detroit Michigan U.S.A
| |
Collapse
|
12
|
|
13
|
Tolisano AM, Justin GA, Ruhl DS, Cable BB. Rhinology and medical malpractice: An update of the medicolegal landscape of the last ten years. Laryngoscope 2015; 126:14-9. [DOI: 10.1002/lary.25533] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 05/15/2015] [Accepted: 07/02/2015] [Indexed: 11/09/2022]
Affiliation(s)
| | - Grant A. Justin
- F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences; Bethesda Maryland U.S.A
| | - Douglas S. Ruhl
- Department of Otolaryngology; Tripler Army Medical Center; Honolulu Hawaii
| | - Benjamin B. Cable
- Department of Otolaryngology; Tripler Army Medical Center; Honolulu Hawaii
| |
Collapse
|
14
|
Farida JP, Lawrence LA, Svider PF, Shkoukani MA, Zuliani GF, Folbe AJ, Carron MA. Protecting the airway and the physician: Aspects of litigation arising from tracheotomy. Head Neck 2015; 38:751-4. [DOI: 10.1002/hed.23950] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/01/2014] [Accepted: 12/10/2014] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jeremy P. Farida
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Lauren A. Lawrence
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Peter F. Svider
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Mahdi A. Shkoukani
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
- Section of Otolaryngology; Department of Surgery; John D. Dingell VA Medical Center; Detroit Michigan
| | - Giancarlo F. Zuliani
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
- Section of Otolaryngology; Department of Surgery; John D. Dingell VA Medical Center; Detroit Michigan
| | - Adam J. Folbe
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Michael A. Carron
- Department of Otolaryngology - Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
- Section of Otolaryngology; Department of Surgery; John D. Dingell VA Medical Center; Detroit Michigan
| |
Collapse
|
15
|
Radvansky BM, Farver WT, Svider PF, Eloy JA, Gubenko YA, Eloy JD. A Comparison of Plaintiff and Defense Expert Witness Qualifications in Malpractice Litigation in Anesthesiology. Anesth Analg 2015; 120:1369-74. [DOI: 10.1213/ane.0000000000000673] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|