Formal Patient Complaints and Malpractice Events Against Pediatric Orthopaedic Surgeons

Abstract

Background: Formal patient complaints are associated with increased malpractice litigation and can have adverse occupational consequences for surgeons. Our purpose was to define and categorize patient complaints within an academic pediatric orthopaedic surgery practice over a 10-year period. We further aimed to define risk factors associated with patient complaints. Methods: We reviewed all complaints within our institution's patient advocacy service filed on behalf of a patient against 4 pediatric orthopaedic surgeons over a 10-year period. Complaints were categorized using the Patient Complaint Analysis System. A control group of all patients seen by the surgeons during the study period was created. We compared baseline demographics between the patients with a complaint and the control group and compared complaint rates between the surgeons. Any malpractice events (lawsuits and claims) associated with the surgeons were obtained. We queried our institutional MIDAS reporting system (which allows for anonymous reporting of potential patient-safety or "near-miss" events), to assess whether patients with a complaint had a reported event.Results: The 4 pediatric orthopaedic surgeons saw a total of 25,747 unique patients during the study period. Forty-one patients had a formal complaint, resulting in a complaint rate of 0.15%. Complaint rates varied from 0.08% to 0.30% between surgeons. Humanness was the most frequent complaint designation category (32%) followed by Care and Treatment (19%). Of the 41 patients with a complaint, 18 (44%) underwent surgical treatment. Only 1 patient with a complaint also had an entry within our institutional patient-safety reporting system. Conclusions: The rate of patient complaints within an academic pediatric orthopaedic surgery practice over a decade was 0.15%, or ~1 complaint for every 670 new patients seen. The majority of patient complaints involved communication; a potentially modifiable area that can be targeted for improvement. While complaint rates among surgeons can vary, patient demographic factors are not associated with increased complaints. Understanding patient complaints rates and types may allow surgeons to target areas for improvement and decrease exposure to malpractice litigation. Level of Evidence: Level II-prognostic.

Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

“…This compares to a 0.20% complaint rate among hand and upper extremity surgeons and a 0.15% complaint rate among pediatric orthopedic surgeons, which have been previously reported by our group. 6,8 These data are consistent with results from Dambrino et al, 9 who demonstrated that spine neurosurgeons had an increased risk of complaints compared with other physicians. Our overall malpractice event rate among the six surgeons was found to be 0.23%.…”

“…Interestingly, while prior series have shown the association between patient demographics (obesity, tobacco use, and worker’s compensation) and surgical complications, these were not associated with complaints in our series or prior similar studies of other orthopedic subspecialties. 6,8,16–18…”

“…Interestingly, while prior series have shown the association between patient demographics (obesity, tobacco use, and worker's compensation) and surgical complications, these were not associated with complaints in our series or prior similar studies of other orthopedic subspecialties. 6,8,[16][17][18] This study has several limitations. The retrospective nature of this study limits the ability to legitimize each patient complaint, meaning that all complaints were weighed equally regardless of their credibility.…”

“…The two most common complaint domains in this study were access & availability and care & treatment, which is consistent with prior reports. 6,8 Nearly one-third of the complaints pertaining to access and availability were due to appointment scheduling delays. It may be prudent for healthcare systems to adequately staff providers and schedulers within their practices to improve access and availability to spine surgeons.…”

Complications and complaints in craniofacial fractures – Finnish national data for 20 years

“…An injury or its treatment can negatively impact a patient's social encounters, mental health, and ability to work, thus lowering their quality of life [14][15][16][17]. Ji et al [18] concluded that up to 34.6% of all patients undergoing a maxillofacial procedure sustain at least minor permanent harm, with the rate of death being up to 5.3%.…”