Bass John B, Couperus Kyle S, Pfaff Jamie L, Moore Gregory P
Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington.
University of Texas Southwestern School of Medicine, Dallas, Texas.
Clin Pract Cases Emerg Med. 2018 Oct 18;2(4):283-285. doi: 10.5811/cpcem.2018.10.39497. eCollection 2018 Nov.
In this article, we present two medicolegal cases illustrating medical and diagnostic pitfalls that can lead to litigation for missed testicular torsion. Testicular torsion (TT) is a urologic emergency with potentially devastating consequences and costs, for providers and patients alike. TT occurs in approximately 4.5 per 100,000 males under the age of 25. While uncommon, TT is the third most common cause of medical malpractice suits in this demographic. As a consequence of varying presentations and physical exam findings, and diagnostic imaging subject to individual interpretation, this time-sensitive diagnosis may be missed by emergency department providers. Delays in diagnosis significantly increases the morbidity associated with TT, and 31.9%-41.9% of such cases result in testicular loss. The average reported settlement for TT malpractice litigation is $60,000. This article discusses two actual malpractice cases involving TT and provides insight and caveats to ensure an optimal evaluation and diagnostic approach to this often-elusive condition.
在本文中，我们呈现了两起法医学案例，这些案例说明了可能导致因漏诊睾丸扭转而引发诉讼的医学和诊断陷阱。睾丸扭转（TT）是一种泌尿外科急症，对医疗服务提供者和患者来说都可能带来极具破坏性的后果和高昂代价。睾丸扭转在每10万名25岁以下男性中约有4.5例发生。虽然并不常见，但在这一人群中，睾丸扭转是医疗事故诉讼的第三大常见原因。由于临床表现和体格检查结果各异，以及诊断成像存在个体解读差异，急诊科医疗服务提供者可能会漏诊这种时间紧迫的病症。诊断延误显著增加了与睾丸扭转相关的发病率，此类病例中有31.9% - 41.9%会导致睾丸丧失。据报道，睾丸扭转医疗事故诉讼的平均和解金额为6万美元。本文讨论了两起涉及睾丸扭转的实际医疗事故案例，并提供了见解和注意事项，以确保对这种常常难以捉摸的病症进行最佳评估和诊断。
