Colaco Marc, Heavner Matthew, Sunaryo Peter, Terlecki Ryan
Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Division of Urology, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
J Emerg Med. 2015 Dec;49(6):849-54. doi: 10.1016/j.jemermed.2015.06.052. Epub 2015 Sep 26.
The litigious nature of the American medical environment is a major concern for physicians, with an estimated annual cost of $10 billion.
The purpose of this study is to identify causes of litigation in cases of testicular torsion and what factors contribute to verdicts or settlements resulting in indemnity payments.
Publicly available jury verdict reports were retrieved from the Westlaw legal database (Thomson Reuters, New York, NY). In order to identify pertinent cases, we used the search terms "medical malpractice" and "testicular torsion" with date ranging from 2000 to 2013. Jury verdicts, depositions, and narrative summaries were evaluated for their medical basis, alleged malpractice, findings, and indemnity payment(s) (if any).
Fifty-two cases were identified that were relevant to this study. Fifty-one percent of relevant cases were found in favor of the defendant physician, with the remaining 49% involving an indemnity payment (13% of which were settled). The most commonly sued medical providers were emergency physicians (48% of defendants), with urologists being second most common and making up 23% of the defendant pool. Emergency physicians were significantly more likely to make indemnity payments than urologists.
Testicular torsion is a delicate condition and requires expertise in evaluation and treatment. When emergency physicians choose not to consult an urologist for possible torsion, they leave themselves open to litigation risk. When an urologist is involved in torsion litigation, they are rarely unsuccessful in their defense. Finally, ultrasound is no guarantee for success against litigation.
美国医疗环境的诉讼性质是医生主要关注的问题，估计每年成本达100亿美元。
本研究的目的是确定睾丸扭转病例中的诉讼原因以及导致判决或和解并产生赔偿支付的因素。
从Westlaw法律数据库（汤森路透，纽约，纽约）检索公开可用的陪审团裁决报告。为了确定相关案例，我们使用搜索词“医疗事故”和“睾丸扭转”，日期范围为2000年至2013年。对陪审团裁决、证词和叙述性摘要进行医学依据、涉嫌医疗事故、调查结果和赔偿支付（如有）方面的评估。
确定了52个与本研究相关的案例。51%的相关案例判定被告医生胜诉，其余49%涉及赔偿支付（其中13%已和解）。最常被起诉的医疗服务提供者是急诊科医生（占被告的48%），其次是泌尿科医生，占被告群体的23%。急诊科医生比泌尿科医生更有可能进行赔偿支付。
睾丸扭转是一种棘手的病症，需要评估和治疗方面的专业知识。当急诊科医生选择不就可能的扭转咨询泌尿科医生时，他们就会面临诉讼风险。当泌尿科医生卷入扭转诉讼时，他们很少在辩护中失败。最后，超声检查并不能保证成功避免诉讼。
