A sneaky surgical emergency: Acute compartment syndrome. Retrospective analysis of 66 closed claims, medico-legal pitfalls and damages evaluation

Legal Aspects of Compartment Syndrome

“…Paresthesias, numbness, or increased compartment tension to palpation were the second common presenting symptoms. Surprisingly, only one study noted the frequency with which compartment pressures were measured, and the frequency was only 25% in their study [7,14]. Other presenting symptoms included the other cardinal signs of compartment syndrome (e.g., pallor, poikilothermia, paralysis, pulselessness, and pain with passive stretch), but these were less frequently noted [7,14].…”

“…When evaluating acute traumatic compartment syndrome, traumatologists were the most commonly named defendants, but when evaluating elective surgery, vascular surgeons (18.2%) were the most commonly sued specialty followed by orthopedists (9.2%) [5]. In one study, orthopedic surgeons were the most common defendants (40.1%) in all claims, followed by nonsurgical providers (38.1%), general surgeons (10.8%), vascular surgeons (6.5%), and plastic surgeons (4.3%) [14]. Understanding the defendants allows us to understand the impact of compartment syndrome on the medical field and how easily one could miss the diagnosis.…”

“…New York (24.5%) and California (18%) were the locations with the majority of the compartment syndrome claims with Michigan (9.4%) a distant third [5]. Between 20% and 27% of compartment syndrome claims were in pediatric patients, and 27-38% of the claims were in female patients [5,7,14]. Men aged 11-30 years old were the highest group of patients presenting with acute compartment syndrome [15].…”

“…The signs and symptoms present in the plaintiffs were examined in many of these studies. Between 55% and 68% patients in the cases presented with severe pain as the primary symptom of compartment syndrome [7,14]. Paresthesias, numbness, or increased compartment tension to palpation were the second common presenting symptoms.…”

Are the less common compartment syndromes less of a problem?

“…Marchesi et al from Italy suggests that this may indeed be a global problem [34]. They reported their results of a retrospective analysis of 66 closed claims, medico-legal pitfalls and damages evaluation.…”