Medical Malpractice Allegations in Nasal Turbinate Surgery

Abstract

Background Despite studies showing most patients significantly improve their nasal congestion with surgical management of nasal turbinates, not all achieve acceptable results. Rarely, patients report substantial worsening of symptoms leading to litigation risk. Objective Document the United States medicolegal environment for nasal turbinate surgery. Methods We searched the Westlaw database for turbinate related terms for 1987- July 2019, recording demographics, claims, legal arguments, and outcomes in legal cases related to nasal turbinate surgery. We assessed prevalence and correlations with case outcomes. Results Of the 39 cases identified, the most common complaint was nose/facial pain (53.8% of cases). Surgeons prevailed in 87.2% of cases, with total liabilities of $3,224,606 [mean $97,715.3, ±$283,900.8]. Surgeons had statistically significant favorable outcomes when patients claimed dryness, headache, congestion, crusting, breathing problems, and disfigurement (all p < 0.05). Revision surgery was indicated in 23.1% of cases and was claimed in 40.0% of patient awards. Surgical negligence was claimed in 40.0% of patient awards versus 67.9% of surgeon awards (p = 0.333). Lack of informed consent was claimed in 20.0% of patient awards versus 32.1% of surgeon awards (p = 0.601). Conclusions There are inherent litigation risks for surgeons when performing nasal turbinate surgery. Most claims against surgeons, are resolved in favor of the surgeon. Understanding the types of claims and legal arguments that are made by patients could help assessing the risks of a proposed litigation. Documenting clear indications for surgery and written informed consent may reduce litigations against surgeons.

To Think Outside the Box Requires Stepping Outside of Your Comfort Zone

“…If key details are omitted, the video consent method could end up being added to the list of common medical malpractice allegations such as those presented in the study by Coppess et al 24 I have no doubt this issue will be valuable and likely largely familiar in scope and topic to you the AJRA readership. However, If you do happen to find yourself outside of your usual comfort zone as I did at times, I encourage you to engross yourself into the unfamiliar until it becomes a little more familiar.…”

“…23 However, such an application clearly would require careful thought about the content and delivery. If key details are omitted, the video consent method could end up being added to the list of common medical malpractice allegations such as those presented in the study by Coppess et al 24…”