Updates in medical malpractice

Ruhl, Douglas S.; Littlefield, Philip D.

doi:10.1097/moo.0000000000000182

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Claims with outcomes that are associated with neurological deficit, including vestibular complications, attract higher total damages and explain why stapedectomy has the highest mean value cost per claim. Additionally, otological operations are often performed on patients who are otherwise medically well and complications for these patients, especially if they involve neurological injury, can equate to high litigation costs if claims are pursued 27 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, otological operations are often performed on patients who are otherwise medically well and complications for these patients, especially if they involve neurological injury, can equate to high litigation costs if claims are pursued. 27 Documented evidence of a recent preoperative audiogram will assist clinicians in claims regarding loss of hearing 28 and are important to help counsel patients. Whilst it is routine to perform preoperative audiometry, vestibular testing is seldom carried out prior to surgery making it more difficult to ascertain whether there has been a change in postoperative vestibular function.…”

Section: Discussionmentioning

confidence: 99%

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Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Navaratnam¹,

Hariri

Ho³

et al. 2020

Clinical Otolaryngology

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Introduction: Litigation against the National Health Service (NHS) in England is rising. The aim of this study was to determine the incidence and characteristics of otorhinolaryngology clinical negligence claims in England. Methods: A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to otorhinolaryngology between April 2013 and April 2018. Analysis was performed using information for cause, patient injury and claim cost. Where claim information was adequately detailed, the authors categorised claims by subspecialty, diagnosis and surgery. Results: A total number of 727 claims were identified with an estimated potential cost of £108 million. Out of these, 463 were closed claims. Including open claim reserves, the mean cost of a claim was £148 923. Head and neck surgery was the subspecialty with the highest number of claims (n = 313, 43%) and highest cost (£51.5 million) followed by otology (n = 171, £24.5 million) and rhinology (n = 171, £13.6 million). Over half of claims were associated with an operation (n = 429, 59%) where mastoid surgery (n = 46) and endoscopic sinus surgery (n = 46) were equally associated with the greatest number of claims. The most frequent causes for clinical negligence claims included failure or delay to diagnose (n = 178, 25%), failure or delay to treat (n = 136, 19%), intra-operative complications (n = 130, 18%) and failure of the consent process (n = 107, 15%). Discussion: Clinical negligence claims in otorhinolaryngology are related to several different components of patient management and are not limited to postoperative complications. This study highlights the importance of robust pathways in outpatient diagnostics and the consenting process in order to deliver better patient care and reduce the impact of litigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Navaratnam¹,

Hariri

Ho³

et al. 2020

Clinical Otolaryngology

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Review of Clinical Settings in Otolaryngology Malpractice Litigation

Talmor

Baredes

2021

Litigation in Otolaryngology

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Vestibular Hypofunction Secondary to Topical Use of Aminoglycosides in Ears with Perforated Tympanic Membrane

González-Aguado,

Veiga-Alonso,

Morales-Angulo

2024

Audiol Neurotol

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Introduction: The objective of this study was to identify and clinically characterize patients treated in an Otoneurology Unit who experienced vestibular ototoxicity as a result of using aminoglycoside ear drops during outbreaks of superinfection in chronic otitis media. Material and methods: An observational retrospective study was conducted, including patients with perforated eardrums who developed vestibular ototoxicity within the past ten years following the application of topical ear aminoglycosides in a tertiary referral center. The study encompassed the assessment of the clinical presentation, treatment, quality of life, and evolution after treatment of the identified individuals. Results: During the study period, six patients, aged between 33 and 71 years, developed vestibular ototoxicity following the use of topical aminoglycoside drops due infection flares in chronic otitis media. All cases involved the use of gentamicin. Two cases were unilateral, and four were unilateral. The onset of symptoms occurred within one to four weeks of using the drops, resulting in all patients experiencing instability without vertigo attacks. After discontinuing the drops and undergoing vestibular rehabilitation, four patients experienced sequelae, with two patients (both with bilateral vestibular hypofunction) suffering significant impairment in their quality of life. Conclusions: Conclusion: Vestibular ototoxicity due to the topical application of aminoglycosides during acute exacerbations of chronic otitis media is a rare occurrence. However, given its potential for severe consequences and the fact that we are still encountering patients with this condition, healthcare professionals should explore alternative antibacterial agents that offer similar efficacy.

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Updates in medical malpractice

Cited by 3 publications

References 36 publications

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Review of Clinical Settings in Otolaryngology Malpractice Litigation

Vestibular Hypofunction Secondary to Topical Use of Aminoglycosides in Ears with Perforated Tympanic Membrane

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