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Gerstl JVE, Gupta S, Stenberg CE, Chabros J, Nonnenbroich LF, Lindberg R, Altshuler MS, Seaver D, Mooney MA, Frerichs KU, Smith TR, Arnaout O. From Operating Room to Courtroom: Analyzing Malpractice Trajectories in Cranial Neurosurgery. Neurosurgery 2024:00006123-990000000-01237. [PMID: 38916340 DOI: 10.1227/neu.0000000000003052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/26/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Nearly all neurosurgeons in the United States will be named defendants in a malpractice claim before retirement. We perform an assessment of national malpractice trends in cranial neurosurgery to inform neurosurgeons on current outcomes, trends over time, benchmarks for malpractice coverage needs, and ways to mitigate lawsuits. METHODS The Westlaw Edge and LexisNexis databases were searched to identify medical malpractice cases relating to open cranial surgery between 1987 and 2023. Extracted data included date of verdict, jurisdiction, outcome, details of sustained injuries, and any associated award/settlement figures. RESULTS Of 1550 cases analyzed, 252 were identified as malpractice claims arising from open cranial surgery. The median settlement amount was $950 000 and the average plaintiff ruling was $2 750 000. The highest plaintiff ruling resulted in an award of $28.1 million. Linear regression revealed no significant relationship between year and defendant win (P-value = .43). After adjusting for inflation, award value increased with time (P-value = .01). The most common cranial subspecialties were tumor (67 cases, 26.6%), vascular (54 cases, 21.4%), infection (23 cases, 9.1%), and trauma (23 cases, 9.1%). Perioperative complications was the most common litigation category (96 cases, 38.1%), followed by delayed treatment (40 cases, 15.9%), failure to diagnose (38 cases, 15.1%), and incorrect choice of procedure (29 cases, 11.5%). The states with most claims were New York (40 cases, 15.9%), California (24 cases, 9.5%), Florida (21 cases, 8.3%), and Pennsylvania (20 cases, 7.9%). CONCLUSION Although a stable number of cases were won by neurosurgeons, an increase in award sizes was observed in the 37-year period assessed. Perioperative complications and delayed treatment/diagnosis were key drivers of malpractice claims.
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Affiliation(s)
- Jakob V E Gerstl
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Saksham Gupta
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Program for Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Jeremy Chabros
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Rebecca Lindberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marcelle S Altshuler
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David Seaver
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael A Mooney
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kai U Frerichs
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy R Smith
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Omar Arnaout
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Haywood N, Kron IL. Commentary: Malpractice in heart transplantation. J Card Surg 2021; 36:2791-2792. [PMID: 34021629 PMCID: PMC8456480 DOI: 10.1111/jocs.15664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/29/2022]
Abstract
The field of heart transplantation is complex and carries substantial risk of medical malpractice. It is essential for heart transplant surgeons to understand litigation trends to minimize risk and continue to optimize patient care. Below we provide commentary on a recent article from the Journal of Cardiac Surgery discussing this topic. The risk of medical malpractice in heart transplantation may be decreased with seamless communication between provider teams, minimizing operative errors, thorough informed consent, and improved provider emotional intelligence.
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Affiliation(s)
- Nathan Haywood
- Division of Thoracic and Cardiovascular Surgery, Department
of Surgery, University of Virginia, Charlottesville, VA
| | - Irving L. Kron
- Division of Thoracic and Cardiovascular Surgery, Department
of Surgery, University of Virginia, Charlottesville, VA
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