Department of Surgery, Mayo Clinic, Rochester, MN, USA.
The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA.
Ann Surg Oncol. 2018 Oct;25(10):2939-2947. doi: 10.1245/s10434-018-6579-2. Epub 2018 Jun 28.
Approximately 15% of general surgeons practicing in the United States face a medical malpractice lawsuit each year. This study aimed to determine the reasons for litigation for breast cancer care during the past 17 years by reviewing a public legal database.
The LexisNexis legal database was queried using a comprehensive list of terms related to breast cancer, identifying all cases from 2000 to 2017. Data were abstracted, and descriptive analyses were performed.
The study identified 264 cases of litigation pertaining to breast cancer care. Delay in breast cancer diagnosis was the most common reason for litigation (n = 156, 59.1%), followed by improperly performed procedures (n = 26, 9.8%). The medical specialties most frequently named in lawsuits as primary defendants were radiology (n = 76, 28.8%), general surgery (n = 74, 28%), and primary care (n = 52, 19.7%). The verdict favored the defendant in 145 cases (54.9%) and the plantiff in 60 cases (22.7%). In 59 cases (22.3%), a settlement was reached out of court. The median plaintiff verdict payouts ($1,485,000) were greater than the settlement payouts ($862,500) (p = 0.04).
Failure to diagnose breast cancer in a timely manner was the most common reason for litigation related to breast cancer care in the United States. General surgery was the second most common specialty named in the malpractice cases studied. Most cases were decided in favor of the defendant, but when the plaintiff received a payout, the amount often was substantial. Identifying the most common reasons for litigation may help decrease this rate and improve the patient experience.
每年约有 15%的美国普通外科医生面临医疗事故诉讼。本研究旨在通过审查公共法律数据库,确定过去 17 年来乳腺癌护理诉讼的原因。
使用与乳腺癌相关的综合术语列表,对 LexisNexis 法律数据库进行查询,确定 2000 年至 2017 年期间的所有病例。提取数据并进行描述性分析。
本研究共确定了 264 例与乳腺癌护理相关的诉讼案件。乳腺癌诊断延迟是最常见的诉讼原因(n=156,59.1%),其次是程序不当(n=26,9.8%)。在诉讼中最常被点名作为主要被告的医疗专业是放射科(n=76,28.8%)、普通外科(n=74,28%)和初级保健科(n=52,19.7%)。在 145 例(54.9%)案件中,判决有利于被告,在 60 例(22.7%)案件中,判决有利于原告。在 59 例(22.3%)案件中,庭外和解。原告判决赔偿中位数为 148.5 万美元,高于和解赔偿中位数 86.2.5 万美元(p=0.04)。
未能及时诊断乳腺癌是美国与乳腺癌护理相关诉讼的最常见原因。普通外科是研究中被点名最多的第二大专科。大多数案件的判决有利于被告,但当原告获得赔偿时,金额往往很高。确定诉讼的最常见原因可能有助于降低这一比率并改善患者体验。