Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases

Kandinov, Aron; Mutchnick, Sean; Nangia, Vaibhuv; Svider, Peter F.; Zuliani, Giancarlo; Shkoukani, Mahdi A.; Carron, Michael A.

doi:10.1001/jamafacial.2016.1782

Cited by 44 publications

(38 citation statements)

References 28 publications

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“…Previous studies have shown litigations in plastic surgery are commonly due to a practitioner's lack of expertise, lack of informed consent, and poor cosmetic outcome. 19,20 With the mean monetary award totaling $242,000 and greater than 50% of patients sustaining permanent injury, 14 further regulation of what defines "qualified" is paramount to our healthcare system. Particularly with the exponential increase in facial filler demand and its interdependence with popular media, future news coverage both locally and internationally can play a vital role in public perception and government policies.…”

Section: Discussionmentioning

confidence: 99%

Public Perception of Facial Fillers

et al. 2019

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There has been widespread coverage of cosmetic procedures, particularly facial fillers, as minimally invasive options for facial rejuvenation. The authors' objective was to characterize news media's coverage of facial fillers and its role in shaping public perception of these products over the past decade. Public view plays a significant role in policymaking, assisting patient communication, and addressing preconceived notions. Google News was searched for online news coverage related to “facial fillers” from 2008 to 2017. News articles from various sources were reviewed and analyzed with multiple objectives including complications listed, advantages, disadvantages, physician specialties, overall theme of the articles as positive, negative, or neutral and other parametrics. A chi-square test was used for statistical analysis. Of 426 articles meeting inclusion criteria, international news (20.4%), tabloids (18.8%), online health sites (18.3%), and national news (16.9%) were represented. Of articles containing adequate information, coverage was 44.7% positive, 29.9% neutral, and 26.1% negative with no significant change from 2008 to 2017. In addition, 46.0% of papers discussed complications including vascular injury and blindness associated with fillers, with significant increase by 2017 (p < 0.05). Facial fillers media coverage was overall positive, with broad coverage at both national and international levels. Complications were discussed often, and although vascular injury and vision damage are rare complications of fillers, they were frequently cited, potentially leading the public to believe they occur frequently. There were also significant concerns in the news media about greater regulation of products used as facial fillers, and practitioners administrating them. Altogether, these findings provide a comprehensive overview of patient perception and expectations of an increasingly popular and expanding cosmetic procedure.

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Section: Discussionmentioning

confidence: 99%

Public Perception of Facial Fillers

et al. 2019

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“…Unfortunately, there is a paucity of well-designed studies analyzing malpractice litigation specific to rhinoplasty. [6][7][8]15,17 The most complete of these studies, published in the Laryngoscope in 2013, reports an analysis of court records pertaining to several different FPS procedures. 6 In their analysis of rhinoplasty-specific claims, the authors used medical malpractice and rhinoplasty as their sole search terms and identified 24 cases related to rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Westlaw and WestlawNext have been used repeatedly to analyze medical malpractice litigation. 6,15,16,[18][19][20] Nexis Uni (formerly LexisNexis Academic) is a subscription-based database which provides access to more than 17 000 business and legal sources from LexisNexis. Nexis Uni has 3 primary collections, 1 of which contains full-text legal documents, including US Federal and State court cases, and law reviews from the late 18th century to present.…”

Section: Data Sourcesmentioning

confidence: 99%

“…Previous examinations of litigation in otolaryngology [8][9][10][11][12][13][14] and facial PS 6,15,16 have been performed; however, the data specific to rhinoplasty are limited. 7,17 The objective of this study was to perform the first comprehensive analysis of the legal allegations, verdicts, and indemnities associated with rhinoplasty medical malpractice litigation cases.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Factors Associated With Malpractice Litigation in Rhinoplasty

et al. 2019

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Rhinoplasty, the third most common cosmetic surgical procedure in the United States, represents the second most litigated facial plastic surgery procedure. Previous examinations of litigation specific to rhinoplasty are limited. The objective of this study was to comprehensively evaluate rhinoplasty malpractice litigation over the past 30 years and to investigate the financial burden of medical malpractice litigation associated with rhinoplasty, as well as factors that contribute to litigation and negative defendant outcomes. Jury verdict and payment reports related to rhinoplasty malpractice litigations over the past 30 years (1988-2018) were obtained using the WestlawNext and Nexis Uni subscription-based legal databases. The term “malpractice” was searched in combination with “rhinoplasty” and various names associated with the procedure. Cases included in the analysis were reviewed for outcomes, verdict payments, defendant specialty, and allegations raised in proceedings. Of the 46 cases identified, 12 (26%) were resolved with a plaintiff verdict payment. The median payment awarded was $127 500 (standard deviation, $96 590.63). The surgeon specialties found for 35 cases included otolaryngology (17 [49%]), plastic surgery (13 [37%]), facial plastic surgery (3 [9%]), and oral/maxillofacial surgery (OMFS; 2 [6%]). A greater proportion of cases involving otolaryngologists were resolved with payment compared with cases involving plastic surgeons (4 [24%] vs 1 [8%]), though this difference did not reach statistical significance ( P = .26). The most common allegations raised among the 46 cases were poor cosmesis (20 [43%]), intraoperative negligence (18 [39%]), inadequate informed consent (13 [28%]), and nasal function deficits (13 [28%]). Cases had a higher likelihood of being resolved in payment when allegations of cosmetic deformity (7%, 95% confidence interval [CI], −17.55 to 31.91) and nasal function deficit (17%, 95% CI, −9.29 to 45.32) were present, nevertheless these findings did not reach statistical significance ( P = .60 and P = .24, respectively). Rhinoplasty malpractice litigation resulting in payments can create substantial financial burden for the defendant. Common factors cited by plaintiffs for pursuing rhinoplasty malpractice litigation included cosmetic deformity, intraoperative negligence, lack of informed consent, and nasal function deficit. Cosmetic deformity and nasal function deficit allegations tended to result in negative defendant outcomes, though these findings are inconclusive. Our findings reinforce the importance of physician-patient communication, including conducting a comprehensive informed consent process, to limit or avoid postsurgical allegations.

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“…Increased reliability of Web site information provides benefits to the practicing surgeon beyond the possibility of increased Web site traffic; better-informed patients are more often satisfied with their results and less likely to be involved in malpractice litigation. [26][27][28] Also, Web site relia-bility and patient trust are associated with the qualifications of the Web site author. Hence it is critical to facilitate access to information on the surgeon's training and board certification status.…”

Section: Discussionmentioning

confidence: 99%

Search Engine Optimization: An Analysis of Rhinoplasty Web sites

et al. 2017

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The Internet is the primary source of information for facial plastic surgery patients. Most patients only analyze information in the first 10 Web sites retrieved. The aim of this study was to determine factors critical for improving Web site traffic and search engine optimization. A Google search of “rhinoplasty” was performed in Michigan. The first 20 distinct Web sites originating from private sources were included. Private was defined as personal Web sites for private practice physicians. The Web sites were evaluated using SEOquake and WooRANK, publicly available programs that analyze Web sites. Factors examined included the presence of social media, the number of distinct pages on the Web site, the traffic to the Web site, use of keywords, such as rhinoplasty in the heading and meta description, average visit duration, traffic coming from search, bounce rate, and the number of advertisements. Readability and Web site quality were also analyzed using the DISCERN and Health on the Net Foundation code principles. The first 10 Web sites were compared with the latter 10 Web sites using Student's t-tests. The first 10 Web sites received a significantly lower portion of traffic from search engines than the second 10 Web sites. The first 10 Web sites also had significantly fewer tags of the keyword “nose” in the meta description of the Web site. The first 10 Web sites were significantly more reliable according to the DISCERN instrument, scoring an average of 2.42 compared with 2.05 for the second 10 Web sites (p = 0.029). Search engine optimization is critical for facial plastic surgeons as it improves online presence. This may potentially result in increased traffic and an increase in patient visits. However, Web sites that rely too heavily on search engines for traffic are less likely to be in the top 10 search results. Web site curators should maintain a wide focus for obtaining Web site traffic, possibly including advertising and publishing information in third party sources such as “RealSelf.”

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Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases

Cited by 44 publications

References 28 publications

Public Perception of Facial Fillers

Public Perception of Facial Fillers

Analysis of Factors Associated With Malpractice Litigation in Rhinoplasty

Search Engine Optimization: An Analysis of Rhinoplasty Web sites

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