A 23-year analysis of litigation in orthopedic elbow surgery

被引:0
|
作者
Brito, Emmanuel [1 ,2 ]
Sherman, Nathan [2 ]
Mahoney, Andrew P. [3 ]
机构
[1] Univ Calif Riverside, Sch Med, Riverside, CA USA
[2] Univ Arizona, Dept Orthopaed Surg, 1501 N Campbell Ave, Tucson, AZ 85724 USA
[3] Tucson Orthopaed Inst, Tucson, AZ USA
关键词
Malpractice; elbow; orthopedic; litigation; settlement; MALPRACTICE LITIGATION;
D O I
10.1016/j.jse.2024.03.012
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The reasons for malpractice litigation in elbow surgery are not well understood. The aim of this study is to report the most frequently litigated surgeries of the elbow and analyze the reasons for litigation and case outcomes. Methods: A retrospective review of the Westlaw legal database was performed, and all federal and state jurisdiction litigation cases involving the elbow from 2000 to 2023 were queried. Cases were excluded if they did not involve an orthopedic surgeon, nor primary elbow injury or procedure. Cases were reviewed for demographic information, surgical procedure based on reference Current Procedural Terminology codes, complications, symptoms, and reasons for litigation. Quantitative information, including settlement and indemnity cost to the defendant orthopedic surgeon, was analyzed. Cases were subdivided based on United States Census Bureau regions and states to assess regional frequency of litigation with analyses of variance. Results: There were 59 cases meeting inclusion criteria from 2000 to 2023. The most litigated cases involved were ulnar nerve transposition/release and open reduction and internal fixation of the proximal radius and/or ulna at the elbow. The most litigated complication was claimed nerve damage (46%) and permanent disability (27%). Of the total cases, the most frequently litigated symptoms were nerve damage (46%) and loss of function (37%), whereas the least frequent was postoperative stiffness (2%). The Pacific region demonstrated the highest litigation rate (20%), whereas the East South Central, Mountain, and New England regions had the lowest litigation rate (3% each). A favorable verdict was given to the defendant orthopedic surgeon in 59% of the cases. The average loss incurred through settlement was $245,590, whereas the average indemnity paid through verdict was $523,334. Conclusion: Operative fixation of the proximal ulna/radius and ulnar nerve release/transposition are the most litigated procedures of the elbow. Litigation is most associated with nerve injury. Across Census Bureau regions, there is no significant difference in monetary cost incurred through settlements and verdict losses. Although a majority of litigated cases are won by the defending orthopedic surgeon, thorough informed consent and perioperative expectation management may mitigate litigation risk. Level of evidence: Level IV; Case Series from Large Database; Descriptive Epidemiology Study (c) 2024 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码:1672 / 1678
页数:7
相关论文
共 33 条
  • [1] Fifty top-cited classic papers in orthopedic elbow surgery: A bibliometric analysis
    Huo, Yan-qing
    Pan, Xiao-han
    Li, Qing-bo
    Wang, Xi-qian
    Jiao, Xie-jia
    Jia, Zhi-wei
    Wang, Shao-jin
    INTERNATIONAL JOURNAL OF SURGERY, 2015, 18 : 28 - 33
  • [2] Litigation Patterns in Inguinal Hernia Surgery: A 25 Year Review
    Grayson, Cary T.
    Criman, Erik T.
    Cefalu, Lindsay M.
    Roedel, Erik Q.
    Hong, Steven S.
    Yheulon, Christopher G.
    JOURNAL OF SURGICAL RESEARCH, 2018, 232 : 266 - 270
  • [3] Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France
    Pioger, Charles
    Jacquet, Christophe
    Abitan, Alexandre
    Odri, Guillaume-Anthony
    Ollivier, Matthieu
    Sonnery-Cottet, Bertrand
    Boisrenoult, Philippe
    Pujol, Nicolas
    KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2021, 29 (05) : 1651 - 1658
  • [4] Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France
    Charles Pioger
    Christophe Jacquet
    Alexandre Abitan
    Guillaume-Anthony Odri
    Matthieu Ollivier
    Bertrand Sonnery-Cottet
    Philippe Boisrenoult
    Nicolas Pujol
    Knee Surgery, Sports Traumatology, Arthroscopy, 2021, 29 : 1651 - 1658
  • [5] Wide variability of shoulder and elbow case volume in orthopedic surgery residency
    Sudah, Suleiman Y.
    Michel, Christopher R.
    Menendez, Mariano E.
    Plyler, Ryan J.
    JOURNAL OF SHOULDER AND ELBOW SURGERY, 2022, 31 (02) : 437 - 444
  • [6] Litigation in orthopedic surgery: What can we do to prevent it? Systematic analysis of 126 legal actions involving four university hospitals in France
    Mouton, J.
    Gauthe, R.
    Ould-Slimane, M.
    Bertiaux, S.
    Putman, S.
    Dujardin, F.
    ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, 2018, 104 (01) : 5 - 9
  • [7] Litigation and Malpractice in Carpal Tunnel Surgery: An Analysis of 60 Successful Claims Over a 10-Year Period (2002-2012)
    Ajwani, Sanil Harji
    Hinduja, Kunal
    JOURNAL OF HAND AND MICROSURGERY, 2016, 8 (02) : 96 - 99
  • [8] The Australian litigation landscape - oral and maxillofacial surgery and general dentistry (oral surgery procedures): an analysis of litigation cases
    Badenoch-Jones, E. K.
    White, B. P.
    Lynham, A. J.
    AUSTRALIAN DENTAL JOURNAL, 2016, 61 (03) : 310 - 316
  • [9] Analysis of Medical Litigation Among Patients with Medical Disputes in Cosmetic Surgery in Taiwan
    Lyu, Shu-Yu
    Liao, Chuh-Kai
    Chang, Kao-Ping
    Tsai, Shang-Ta
    Lee, Ming-Been
    Tsai, Feng-Chou
    AESTHETIC PLASTIC SURGERY, 2011, 35 (05) : 764 - 772
  • [10] Analysis of Medical Litigation Among Patients with Medical Disputes in Cosmetic Surgery in Taiwan
    Shu-Yu Lyu
    Chuh-Kai Liao
    Kao-Ping Chang
    Shang-Ta Tsai
    Ming-Been Lee
    Feng-Chou Tsai
    Aesthetic Plastic Surgery, 2011, 35 : 764 - 772