Malpractice Litigation and Testicular Torsion: A Legal Database Review

Colaco, Marc; Heavner, Matthew G.; Sunaryo, Peter; Terlecki, Ryan

doi:10.1016/j.jemermed.2015.06.052

Cited by 45 publications

(46 citation statements)

References 20 publications

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“…Our results coincide greatly with the Colaco et al findings [8]. This group used the Westlaw legal database, which also looks at state and federal cases.…”

Section: Discussionsupporting

confidence: 91%

“…To date, only two studies have explored testicular torsion malpractice cases, each exploring different levels of the US judicial system (county versus state) [7,8]. One study found that litigation focused mostly against urologists at the county level [7].…”

Section: Introductionmentioning

confidence: 99%

“…One study found that litigation focused mostly against urologists at the county level [7]. A more recent study found litigation focused mostly against emergency room physicians at the state level [8]. Although these studies are informative, they are mostly descriptive.…”

Section: Introductionmentioning

confidence: 99%

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State appellant cases for testicular torsion: Case review from 1985 to 2015

Gaither

Copp

2016

Journal of Pediatric Urology

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Summary Objective Testicular torsion is one of the most common diagnoses involved in lawsuits in the pediatric patient. Missed diagnosis and diagnostic delays put patients at risk for testicular loss and have resulted in malpractice litigation. Using a national database, we sought to describe testicular torsion malpractice cases tried at the state and federal level and investigate factors associated with successful defense by the provider. Method We reviewed the Lexis Nexis academic legal database. We searched all cases using the terms “testicular torsion” and “medical malpractice” from 1985 to 2015. From this search, we compiled various medical and legal aspects of the case including the outcome of the trial. We performed multivariate logistic regression to determine which factors were associated with successful defense at the state level. Results Fifty-three malpractice cases of testicular torsion were included. State appeals were in favor of providers in 26 (50%) of cases. The average time between initial presentation of the patient and the state verdict decision was 5 years. Emergency room (ER) physicians were the most common provider sued (35%). Approximately half of the patients (26, 51%) first presented to the ER, and atypical presentations were common, as 16 (31%) presented with abdominal pain only. The proportion of patients with false-negative ultrasounds was 16 of 25 (64%). If the patient first presented to the ER, the doctor was less likely to have a successful defense (OR = 0.23; 95% CI 0.06–0.79]). Most verdicts (8/9, 89%) were in favor of urologists. One urologist lost at the state level because of delayed time to the operating room. Conclusions Atypical clinical presentations and false-negative ultrasound findings are common in testicular torsion malpractice litigation at the state and federal level. Providers who used ultrasound were not more likely to win the state appeal, and providers whose patients presented to the ER were less likely to have a successful defense. Although 50% of providers won the state appeal, the time from initial patient presentation and final state verdict decision was substantial.

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“…Our results coincide greatly with the Colaco et al findings [8]. This group used the Westlaw legal database, which also looks at state and federal cases.…”

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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State appellant cases for testicular torsion: Case review from 1985 to 2015

Gaither

Copp

2016

Journal of Pediatric Urology

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“…A majority of malpractice claims involving testicular torsion cite failure of diagnosis, [17][18][19] and the most common claim of breech of standard of care is failure to perform a GU examination. 19 Gaither and Copp 19 highlight the importance of a GU examination in their review of state appellant cases for testicular torsion in which 31% of identified claims were issued in cases where abdominal pain was the only presenting symptom.…”

Section: Discussionmentioning

confidence: 99%

“…Literature also identifies failure to order appropriate scrotal imaging as a potential contributor to misdiagnosis. 17,19 Cases of testicular torsion discovered after unnecessary appendectomy or abdominal exploration have been reported. 10,13 In addition to the 12 misdiagnosed patients, another 12 patients withheld symptoms from their parents more than 24 hours.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Delayed Presentation and Misdiagnosis of Testicular Torsion: A Case-Control Study

Bayne

Villanueva

Davis

et al. 2017

The Journal of Pediatrics

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Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases

Kandinov

Mutchnick

Nangia

et al. 2017

JAMA Facial Plast Surg

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IMPORTANCE This study investigates the financial burden of medical malpractice litigation associated with rhytidectomies, as well as factors that contribute to litigation and poor defendant outcomes, which can help guide physician practices.OBJECTIVE To comprehensively evaluate rhytidectomy malpractice litigation.DATA SOURCES AND STUDY SELECTION Jury verdict and settlement reports related to rhytidectomy malpractice litigations were obtained using the Westlaw Next database. Use of medical malpractice in conjunction with several terms for rhytidectomy, to account for the various procedure names associated with the procedure, yielded 155 court cases. Duplicate and nonrelevant cases were removed, and 89 cases were included in the analysis and reviewed for outcomes, defendant specialty, payments, and other allegations raised in proceedings.

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Malpractice Litigation and Testicular Torsion: A Legal Database Review

Cited by 45 publications

References 20 publications

State appellant cases for testicular torsion: Case review from 1985 to 2015

State appellant cases for testicular torsion: Case review from 1985 to 2015

Factors Associated with Delayed Presentation and Misdiagnosis of Testicular Torsion: A Case-Control Study

Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases

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