Lynn-Macrae Alastair G, Lynn-Macrae Rebecca A, Emani Janaki, Kern Robert C, Conley David B
Department of Otolaryngology, Northwestern University Medical School, Chicago, IL 60611, USA.
Laryngoscope. 2004 Aug;114(8):1492-5. doi: 10.1097/00005537-200408000-00032.
To survey the causes, characteristics, and outcomes of malpractice litigation resulting from injuries sustained during endoscopic sinus surgery (ESS).
A retrospective analysis of United States state and federal civil litigation involving injuries resulting from ESS.
Sources were state and federal court decisions and jury verdict reports accessed through a computerized legal database. The 41 cases were decided or settled between 1990 and 2003. The cases and reports were analyzed for pertinent data regarding plaintiffs, defendants, allegations of wrongdoing, resulting injury, expert witnesses, and resulting verdict or settlement. Correlation between severity of injury and case outcome was analyzed.
All suits reviewed involved ESS. Many cases included multiple causes of action, or types of malpractice, including negligent technique, 31 (76%); lack of informed consent, 15 (37%); and wrongful death, 2 (5%). The defendant-physician specialty was overwhelmingly otolaryngology, 40 (98%). The most common presenting complaint, or indication for surgery, was chronic sinusitis, 30 (73%). The injuries caused by surgery were frequently multiple, including cerebrospinal fluid (CSF) leak, 10 (24%); brain damage, 6 (15%); diplopia, 7 (17%); and death, 2 (5%). The majority of cases reviewed (83%) resulted in a verdict rather than settlement. The result of the verdict or settlement was 17 (41%) in favor of the plaintiff, 23 (56%) in favor of the defendant, and 1 (2%) unknown. The average award was 751,275 dollars, with a median of 410,239 dollars and a range of 61,000 dollars to 2,870,000 dollars.
This is the first study to review malpractice litigation resulting from injuries sustained during ESS and shows a hitherto unexpected pattern between severity of injury and case outcome.
调查鼻内镜鼻窦手术（ESS）期间受伤导致的医疗事故诉讼的原因、特点及结果。
对美国州和联邦涉及ESS所致伤害的民事诉讼进行回顾性分析。
资料来源为通过计算机化法律数据库获取的州和联邦法院判决及陪审团裁决报告。41例案件于1990年至2003年间作出判决或达成和解。对这些案件及报告分析了有关原告、被告、不当行为指控、所导致的伤害、专家证人以及判决结果或和解情况的相关数据。分析了伤害严重程度与案件结果之间的相关性。
所有审查的诉讼均涉及ESS。许多案件包含多种诉讼理由或医疗事故类型，包括技术疏忽，31例（76%）；缺乏知情同意，15例（37%）；以及 wrongful death（原文有误，可能是“wrongful death”，即“不当死亡”），2例（5%）。被告医生的专业绝大多数是耳鼻喉科，40例（98%）。最常见的就诊主诉或手术指征是慢性鼻窦炎，30例（73%）。手术造成的伤害往往是多种的，包括脑脊液（CSF）漏，10例（24%）；脑损伤，6例（15%）；复视，7例（17%）；以及死亡，2例（5%）。大多数审查的案件（83%）以判决而非和解告终。判决或和解结果为17例（41%）有利于原告，23例（56%）有利于被告，1例（2%）未知。平均赔偿金额为751,275美元，中位数为410,239美元，范围为61,000美元至2,870,000美元。
这是第一项回顾ESS期间受伤导致的医疗事故诉讼的研究，并显示了伤害严重程度与案件结果之间迄今未预料到的模式。
