Neurosurgical experience with malpractice litigation: an analysis of closed claims against neurosurgeons in New York State, 1999 through 2003

Rovit, Richard L.; Simon, Arlene Stolper; Drew, John H.; Murali, Raj; Robb, James H.

doi:10.3171/jns.2007.106.6.1108

Cited by 62 publications

(56 citation statements)

References 12 publications

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“…Past studies have been limited to physician surveys 12,13,15,20 and singleinstitution experiences, 5,14 have solely focused on the size of malpractice claims, 5,7,12,14,17 or have been multicenter studies of specific US regions or data subgroups. 3,12,17,19 In contrast, the present investigation specifically evaluated spine surgery data by including the specialties of neurosurgery and orthopedic surgery and by using claims data from litigation cases from around the country.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have evaluated neurosurgical and orthopedic malpractice claims data; 1,[3][4][5][6][7][9][10][11][12][13][14]17,19,20 however, none has focused specifically on spine surgery. Past studies have been limited to physician surveys 12,13,15,20 and singleinstitution experiences, 5,14 have solely focused on the size of malpractice claims, 5,7,12,14,17 or have been multicenter studies of specific US regions or data subgroups.…”

Section: Discussionmentioning

confidence: 99%

“…A delay in diagnosis of the complication occurred in 10.4% of cases (22 cases) and a delay in its treatment in 8.1% of cases (19). Orthopedic surgeons were sued in 136 cases (58% of all cases), while neurosurgeons and nonsurgical specialties were sued in 79 (34%) and 19 (8%) cases, respectively.…”

Section: Case Characteristicsmentioning

confidence: 99%

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Malpractice litigation following spine surgery

Daniels

Ruttiman

Eltorai

et al. 2017

Journal of Neurosurgery: Spine

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OBJECTIVEAdverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation.METHODSA search for “spine surgery” spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC). Demographic data for the plaintiff and defendant in addition to clinical data for the procedure and legal outcomes were examined. Spinal cord injury, anoxic/hypoxic brain injury, and death were classified as catastrophic complications; all other complications were classified as noncatastrophic. Both chi-square and t-tests were used to evaluate the effect of these variables on case outcomes and awards granted.RESULTSA total of 569 legal cases were examined; 335 cases were excluded due to irrelevance or insufficient information. Of the 234 cases included in this investigation, 54.2% (127 cases) resulted in a defendant ruling, 26.1% (61) in a plaintiff ruling, and 19.6% (46) in a settlement. The awards granted for plaintiff rulings ranged from $134,000 to $38,323,196 (mean $4,045,205 ± $6,804,647). Awards for settlements ranged from $125,000 to $9,000,000 (mean $1,930,278 ± $2,113,593), which was significantly less than plaintiff rulings (p = 0.022). Compared with cases without a delay in diagnosis of the complication, the cases with a diagnostic delay were more likely to result in a plaintiff verdict or settlement (42.9% vs 72.7%, p = 0.007) than a defense verdict, and were more likely to settle out of court (17.5% vs 40.9%, p = 0.008). Similarly, compared with cases without a delay in treatment of the complication, those with a therapeutic delay were more likely to result in a plaintiff verdict or settlement (43.7% vs 68.4%, p = 0.03) than a defense verdict, and were more likely to settle out of court (18.1% vs 36.8%, p = 0.04). Overall, 28% of cases (66/234) involved catastrophic complications. Physicians were more likely to lose cases (plaintiff verdict or settlement) with catastrophic complications (66.7% vs 37.5%, p < 0.001). In cases with a plaintiff ruling, catastrophic complications resulted in significantly larger mean awards than noncatastrophic complications ($6.1M vs $2.9M, p = 0.04). The medical specialty of the provider and the age or sex of the patient were not associated with the case outcome or award granted (p > 0.05). The average time to a decision for defendant verdicts was 5.1 years; for plaintiff rulings, 5.0 years; and for settlements, 3.4 years.CONCLUSIONSDelays in the diagnosis and the treatment of a surgical complication predict legal case outcomes favoring the plaintiff. Catastrophic complications are linked to large sums awarded to the plaintiff and are predictive of rulings against the physician. For physician defendants, the costs of settlements are significantly less than those of losing in court. Although this study provides potentially valuable data from a large series of postoperative litigation cases, it may not provide a true representation of all jurisdictions, each of which has variable malpractice laws and medicolegal environments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Malpractice litigation following spine surgery

Daniels

Ruttiman

Eltorai

et al. 2017

Journal of Neurosurgery: Spine

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“…Datos intermedios se publican en un estudio realizado en Burlington (USA) en el año 2006 sobre una muestra de 275 casos de reclamaciones por malpraxis, el 42% correspondían a cirugía espinal, datos similares a un estudio realizado en 1985 sobre una muestra de 300 reclamaciones por malpraxis 2 . En el estudio sobre un periodo de cinco años sobre 280 casos desde el 1 de enero de 1999 al 30 de diciembre de 2003 del New York Medical College, se obtuvieron los siguientes resultados tras examinar la demanda, el lugar anatómico y la resolución del caso: 156 (56%) correspondían a la columna, 109 (39%) la cabeza y/o el cerebro, quedando 15 casos (5%) en una miscelánea 6 . 3.…”

Section: Discussionunclassified

Análisis de las sentencias judiciales contra neurocirujanos resueltas en segunda instancia en España entre 1995 y 2007

et al. 2010

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Recibido:53 Neurocirugía 2010; 21: 53-60 Resumen Objetivos. Con el fin de identificar los factores relacionados con las condenas judiciales contra neurocirujanos, el presente estudio analiza todas las sentencias emitidas en segunda instancia en España contra neurocirujanos en el periodo de 1995 al 2007.Material y método. De un total de 1899 sentencias de segunda instancia o última durante el periodo de 1995 a 2007 emitidas en España se han escogido 61 que cumplen los criterios de inclusión para nuestro estudio. Se han cumplimentado 25 variables en la ficha de recogida de datos. Se ha realizado con ellas un completo estudio descriptivo y comparativo, además de un análisis de la tipología de las demandas, las circunstancias y los profesionales implicados.Resultados. En un tercio de los casos se apreció completa mal praxis. En relación a las condenas, se absolvió aproximadamente en la mitad de los casos, siendo las resueltas con condena 1/5 de ellas de carácter penal y 4/5 indemnizatorias. Las cuantías indemnizatorias predominan en el rango de 60.000 a 600.000 euros. En un 17% de las demandas se apreció deficiencia en la información o el consentimiento. El 62,5% de las intervenciones de nuestra muestra se produjeron en la región anatómica de la columna vertebral siguiéndole en frecuencia la región craneal con un 28,6%. De las consecuencias del procedimiento quirúrgico las secuelas permanentes mayores constituyen el 40% de los casos y el fallecimiento el 22%.Conclusiones. Es rentable dedicar tiempo a la relación con el paciente, incluyendo el consentimiento informado verbal, que debe ser refrendado por la firma del documento que lo recoge. También es importante dejar constancia escrita de la praxis, tanto en lo referente a los procesos quirúrgicos como al diagnóstico y seguimiento del paciente. No se debe bajar la guardia ante procedimientos de menor riesgo vital, como la patología degenerativa, ya que son los más demandados. La demanda más importante tiene que ver con la satisfacción económica, especialmente en la práctica privada.PALABRAS CLAVE: Sentencias judiciales. Condenas. Indemnizaciones. Mal praxis. Neurocirugía. Material and methods. Of a total of 1899 sentences of the second or last appeal, during the period from 1995 to 2007 issued in Spain, 61 were chosen which fulfill the criteria to be included in our study. 25 variables were included on the record of compiled data. A complete descriptive and comparative study was elaborated, as well as an analysis of the type of suits, circumstances, and professionals involved. Analysis of Judicial Sentences Against NeurosurgeonsResults. In a third of the cases, complete malpraxis was identified. In regards to the sentences, they were absolved in approximately half the cases, resolved with one fifth of the cases being penal, and four fifths with compensation. Indemnity quantities range from 60,000 to 600,000€. Deficiency of information or consent was noted in 17% of lawsuits. 62.5% of operations in our sample were on the anatomic region of the vertebral column fo...

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“…Neurosurgeons are a high-risk group for allegations of malpractice; also theyare humans and they do make mistakes -"Errarehumanumestsedperseverarediabolicum" (Seneca). The most frequent allegations 56% involved the spinal surgery cases, 39% the head and/or brain and 5% are miscellaneous (1). Of particular significance in terms of improved diagnostic methodology were spinal operations at the wrong level as well as failure to diagnose sentinel bleeds, aneurysms, arteriovenous malformation and other cerebral lesions (2).…”

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confidence: 99%