Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey.
Laryngoscope. 2013 Sep;123(9):2099-103. doi: 10.1002/lary.24000. Epub 2013 Feb 12.
OBJECTIVES/HYPOTHESIS: In this study, we detailed factors governing legal outcomes in iatrogenic orbital injury, with the purpose of discussing strategies to minimize liability and enhance patient safety.
Retrospective analysis.
Jury verdict and settlement reports were searched from publically available federal and state court records using the Westlaw database (Thomson Reuters, New York, NY). After exclusion of nonrelevant cases, 20 cases of iatrogenic orbital injuries were examined for factors such as legal outcome, damages awarded, defendant specialty, alleged causes of malpractice, and patient demographic information.
The majority (60.0%) of cases were resolved in the defendant's favor. Payment was considerable for the cases decided in support of the plaintiff, averaging $1.13 million. Out-of-court settlements averaged $1.78 million (range, $487,500-$3.9 million), whereas jury-awarded damages averaged $472,661 (range, $75,000-$763,214). Complications stemming from endoscopic sinus surgery were most common (50.0%). Diplopia was the most common medical complaint (50.0%), whereas permanent deficits and having to undergo additional surgery were each present in 65.0% of cases.
The potential for permanent sequelae of iatrogenic orbital injury makes this complication susceptible to malpractice litigation. Otolaryngologists were the most common defendants. Although cases were resolved in the defendant's favor 60% of the time, payments made were considerable, averaging $1.13 million. Steps to minimize liability and improve patient safety include an informed consent process explicitly listing risks, including diplopia and blindness, and obtaining timely ophthalmology consultation when a complication is recognized.
目的/假设：本研究详细阐述了医源性眼眶损伤相关法律后果的决定因素，旨在讨论降低责任风险和提高患者安全性的策略。
回顾性分析。
使用 Westlaw 数据库（Thomson Reuters，纽约，NY）从公开的联邦和州法院记录中搜索陪审团裁决和和解报告。排除不相关的病例后，对 20 例医源性眼眶损伤病例进行了研究，分析了法律结果、判给的损害赔偿金、被告专业、医疗事故的疑似原因以及患者人口统计学信息等因素。
大多数（60.0%）案件对被告有利。支持原告的案件的赔偿金额较大，平均为 113 万美元。庭外和解平均为 178 万美元（范围，48.75 万美元至 390 万美元），而陪审团判给的损害赔偿金平均为 47.2661 万美元（范围，7.5 万美元至 76.3214 万美元）。内窥镜鼻窦手术引起的并发症最常见（50.0%）。复视是最常见的医疗投诉（50.0%），而永久性损伤和需要接受额外手术的情况在 65.0%的病例中出现。
医源性眼眶损伤的永久性后遗症使这种并发症容易发生医疗事故诉讼。耳鼻喉科医生是最常见的被告。尽管 60%的案件以被告胜诉的方式解决，但支付的款项金额可观，平均为 113 万美元。降低责任风险和提高患者安全性的措施包括明确列出风险的知情同意程序，包括复视和失明，并在出现并发症时及时获得眼科咨询。
