Rawal Rounak B, Kilpatrick Lauren A, Wood Jeyhan S, Drake Amelia F
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina - Chapel Hill, 170 Manning Drive, CB #7070, Physician's Office Building Room G-190, Chapel Hill, NC 27599-7040, USA.
Division of Plastic Surgery, University of North Carolina - Chapel Hill, 7040 Burnett-Womack, CB #7195 Chapel Hill, NC 27599-7040, USA.
Int J Pediatr Otorhinolaryngol. 2016 Nov;90:214-219. doi: 10.1016/j.ijporl.2016.09.030. Epub 2016 Sep 24.
To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities.
A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice.
Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058).
Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions.
描述唇腭裂和/或颅面畸形患者的医疗事故趋势。
采用改良的德尔菲法收集检索词。检索设置包括“所有陪审团裁决和和解协议”，管辖范围为“所有州”和“所有联邦法院”（按法院和巡回法院）。对WestLawNext法律数据库进行回顾性审查。如果案件与患者的颅面畸形没有直接关联或与医疗事故无关，则予以排除。
42例病例符合纳入标准。纳入了1981年至2014年结案的病例。有赔偿支付的索赔案件的平均赔偿金额为390万美元。在提交审判的案件中，62%的案件有利于原告。在被列为共同被告的医生中，儿科医生被提及的最为常见（24%），其次是整形外科医生（16%）、产科医生（7.8%）和放射科医生（7.8%）。“漏诊”是最常见的过失索赔类型（45%），其次是“手术失误”（21%）和“用药失误”（17%）。“缺氧性脑损伤”导致患者管理并发症的赔偿中位数最高（350万美元），其次是“错误出生”（103万美元）和“轻微身体伤害”（52万美元）。没有特定类型的过失索赔（p = 0.764）或患者管理并发症（p = 0.61）与更高的赔偿支付相关。2001年之前的平均赔偿金额为92万美元，2001年之后为440万美元（p = 0.058）。
与普通人群相比，患者的平均赔偿金额高出14倍（390万美元对274,887美元），比普通儿科人群高出7倍（390万美元对520,923美元）。所有医疗保健提供者都应意识到，在治疗有这些疾病风险的患者时可能会产生相关的医疗事故索赔。
