Delayed in diagnosis of upper aerodigestive tract cancers: A comprehensive review of medical malpractice cases

Abstract

Background Factors that prompt litigation and influence outcomes for malpractice cases involving cancers of the upper aerodigestive tract are incompletely described. Methods Westlaw, a national legal database, was searched for medical malpractice claims related to upper aerodigestive tract cancer for all years available. Results Of the 122 cases meeting inclusion criteria, 106 (86.9%) involved allegations of failure to diagnose or delay in diagnosis. Tongue, larynx, and nasopharynx cancers were more frequently litigated than would be expected based on their incidence (tongue, 38.7% of aerodigestive tract litigation vs. 26.9% of aerodigestive tract cancers; larynx, 33.0% vs. 22.3%; nasopharynx, 10.4% vs. 4.6%). Payouts were made in over half of diagnosis failure lawsuits (56.6%), which carried an average award of $2840690 [IQR 850219–2537509]. Conclusions An awareness of litigation on cancers of the upper aerodigestive tract holds the potential to improve patient care and help otolaryngologists avoid potential risks for litigation.

Antibiotic Prescribing Prior to Head and Neck Cancer Diagnosis—Warning, Detour Ahead

“…For HNC, nearly 90% of the lawsuits proceeding to litigation are related to failure to diagnose or delay in diagnosis. 5 With this background, Gallogly et al 6 in this issue of JAMA Otolaryngology-Head & Neck Surgery make a number of im-portant contributions to our understanding of diagnostic errors and delays among patients with HNC. In this retrospective cohort study, they investigated the frequency of antibiotic prescription prior to an HNC diagnosis, the association of antibiotic prescriptions with time-to-HNC diagnosis, and factors associated with this occurrence among 7811 patients with HNC from 2011 to 2018 in the Optum deidentified Integrated Claims-Clinical data set.…”

“…Finally, delayed or missed cancer diagnoses are among the leading causes of medical malpractice lawsuits in the US. For HNC, nearly 90% of the lawsuits proceeding to litigation are related to failure to diagnose or delay in diagnosis …”

Inequities Associated With Advanced Stage at Presentation of Head and Neck Cancer

“…Second, widespread dissemination and adoption of clinical practice guidelines are needed . These guidelines support rapid workup of suggestive symptoms with appropriate diagnostic testing to reduce delays in diagnosis and, ultimately, prevent excess morbidity and mortality …”

“…7 These guidelines support rapid workup of suggestive symptoms with appropriate diagnostic testing to reduce delays in diagnosis and, ultimately, prevent excess morbidity and mortality. 8,9 While the drivers of advanced-stage presentation come from a multitude of sources, SDoH play a meaningful role. 10 Prior studies have outlined specific individual characteristics that are associated with stage at presentation of HNC.…”