Kandinov Aron, Mutchnick Sean, Nangia Vaibhuv, Svider Peter F, Zuliani Giancarlo F, Shkoukani Mahdi A, Carron Michael A
Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan.
Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan2Division of Facial Plastic and Reconstructive Surgery, Wayne State University School of Medicine, Detroit, Michigan.
JAMA Facial Plast Surg. 2017 Jul 1;19(4):255-259. doi: 10.1001/jamafacial.2016.1782.
This study investigates the financial burden of medical malpractice litigation associated with rhytidectomies, as well as factors that contribute to litigation and poor defendant outcomes, which can help guide physician practices.
To comprehensively evaluate rhytidectomy malpractice litigation.
Jury verdict and settlement reports related to rhytidectomy malpractice litigations were obtained using the Westlaw Next database. Use of medical malpractice in conjunction with several terms for rhytidectomy, to account for the various procedure names associated with the procedure, yielded 155 court cases. Duplicate and nonrelevant cases were removed, and 89 cases were included in the analysis and reviewed for outcomes, defendant specialty, payments, and other allegations raised in proceedings. Data were collected from November 21, 2015, to December 25, 2015. Data analysis took place from December 25, 2015, to January 20, 2016.
A total of 89 cases met our inclusion criteria. Most plaintiffs were female (81 of 88 with known sex [92%]), and patient age ranged from 40 to 76 years (median age, 56 years). Fifty-three (60%) were resolved in the defendant's favor, while the remaining 36 cases (40%) were resolved with either a settlement or a plaintiff verdict payment. The mean payment was $1.4 million. A greater proportion of cases involving plastic surgeon defendants were resolved with payment compared with cases involving defendants with ear, nose, and throat specialty (15 [36%] vs 4 [24%]). The most common allegations raised in litigation were intraoperative negligence (61 [69%]), poor cosmesis or disfigurement (57 [64%]), inadequate informed consent (30 [34%]), additional procedures required (14 [16%]), postoperative negligence (12 [14%]), and facial nerve injury (10 [11%]). Six cases (7%) involved alleged negligence surrounding a "lifestyle-lift" procedure, which tightens or oversews the superficial muscular aponeurosis system layer.
In this study, although most cases of rhytidectomy malpractice litigation were resolved in the defendant's favor, cases resulting in payments created substantial financial burden for the defendants. Common factors cited by plaintiffs for pursuing litigation included dissatisfaction with cosmetic outcomes and perceived deficits in informed consent. These factors reinforce the importance of a comprehensive, preoperative informed consent process in which the specific potential risks and outcomes are presented by the surgeon to the patient to limit or avoid postsurgical allegations. Intraoperative negligence and facial nerve injury were significantly more likely to result in poor defendant outcomes.
NA.
本研究调查了与除皱手术相关的医疗事故诉讼的财务负担，以及导致诉讼和被告不良结果的因素，这有助于指导医生的临床实践。
全面评估除皱手术医疗事故诉讼。
使用Westlaw Next数据库获取与除皱手术医疗事故诉讼相关的陪审团裁决和和解报告。将医疗事故与几个除皱手术术语结合使用，以涵盖与该手术相关的各种程序名称，共产生155起法庭案件。去除重复和不相关的案件后，89起案件被纳入分析，并对结果、被告专业、赔偿金额以及诉讼中提出的其他指控进行审查。数据收集时间为2015年11月21日至2015年12月25日。数据分析时间为2015年12月25日至2016年1月20日。
共有89起案件符合我们的纳入标准。大多数原告为女性（88名已知性别的原告中有81名[92%]），患者年龄在40至76岁之间（中位年龄为56岁）。53起案件（60%）以被告胜诉结案，其余36起案件（40%）以和解或原告胜诉获得赔偿结案。平均赔偿金额为140万美元。与涉及耳鼻喉科专业被告的案件相比，涉及整形外科医生被告的案件中以赔偿结案的比例更高（15起[36%]对4起[24%]）。诉讼中提出的最常见指控是术中疏忽（61起[69%]）、美容效果差或毁容（57起[64%]）、知情同意不足（30起[34%]）、需要额外手术（14起[16%]）、术后疏忽（12起[14%]）以及面神经损伤（10起[11%]）。6起案件（7%）涉及围绕“生活方式提升”手术的疏忽指控，该手术用于收紧或缝合表浅肌肉腱膜系统层。
在本研究中，尽管大多数除皱手术医疗事故诉讼案件以被告胜诉结案，但导致赔偿的案件给被告带来了巨大的财务负担。原告提起诉讼的常见因素包括对美容效果不满意以及认为知情同意存在缺陷。这些因素强化了全面的术前知情同意程序的重要性，在该程序中，外科医生应向患者告知具体的潜在风险和结果，以限制或避免术后指控。术中疏忽和面神经损伤显著更有可能导致被告的不良结果。
无。
