Hartnett Davis A, DeFroda Steven F, Ahmed Shaan A, Eltorai Adam E M, Blankenhorn Brad, Daniels Alan H
Warren Alpert Medical School of Brown University, Providence, RI, USA.
Orthop Rev (Pavia). 2020 Apr 28;12(1):8439. doi: 10.4081/or.2020.8439. eCollection 2020 Apr 22.
Surgery of the foot constitutes a substantial portion of orthopedic procedures, performed by both orthopedic surgeons and doctors of podiatric medicine. Little research exists on the medicolegal implications of foot surgery amongst these specialties. This study seeks to investigate the different medical and legal factors associated with foot surgery-based malpractice litigation. Malpractice data between 2004 and 2017 was collected using the VerdictSearch legal database. Cases involving foot surgery were identified, and case information including physician specialty, procedure, medical outcome, verdict, and payment amount were obtained. A total of 72 cases were analyzed. A majority of lawsuits involved podiatrists (76.4%), with orthopedic surgeons accounting for 15.3%. Lawsuits against podiatrists primarily occurred over elective procedures (94.5%) and most frequently involved plaintiff complaints of persistent pain (41.8%) or deformation (27.3%). Podiatrist cases most often involved allegations of failure to treat (45.5%) or inappropriate surgical procedure (27.3%). Orthopedic surgeons saw higher rates of urgent cases (45.5%), with surgical complications (27.3%) occurring at higher rates than podiatrists. Despite different trends in case types, similar rates of plaintiff victories, and mean payments were seen between podiatrists (25.5%, $911,884 ± 1,145,345) and orthopedic surgeons (27.3%, $975,555 ± 448,795). This investigation is the first to analyze malpractice trends amongst podiatrists and orthopedic surgeons. Differing factors related to medical and legal outcomes can suggest quality improvement targets for both specialties. This data may assist in reducing malpractice risk and refining patient care, particularly with regards to outlining risks, benefits, and alternatives during pre-operative counselling.
足部手术在骨科手术中占很大一部分，骨科医生和足病医学医生都可进行此类手术。关于这些专业领域中足部手术的法医学影响，相关研究较少。本研究旨在调查与基于足部手术的医疗事故诉讼相关的不同医学和法律因素。使用VerdictSearch法律数据库收集了2004年至2017年期间的医疗事故数据。识别出涉及足部手术的病例，并获取了包括医生专业、手术、医疗结果、裁决和赔偿金额在内的病例信息。共分析了72例病例。大多数诉讼涉及足病医生（76.4%），骨科医生占15.3%。针对足病医生的诉讼主要发生在择期手术中（94.5%），最常见的是原告抱怨持续疼痛（41.8%）或畸形（27.3%）。足病医生的病例最常涉及未治疗指控（45.5%）或不适当的手术程序（27.3%）。骨科医生处理的急症病例比例较高（45.5%），手术并发症发生率（27.3%）高于足病医生。尽管病例类型存在不同趋势，但足病医生（25.5%，911,884美元±1,145,345美元）和骨科医生（27.3%，975,555美元±448,795美元）的原告胜诉率和平均赔偿金额相似。本调查首次分析了足病医生和骨科医生之间的医疗事故趋势。与医学和法律结果相关的不同因素可为这两个专业领域指明质量改进目标。这些数据可能有助于降低医疗事故风险并优化患者护理，特别是在术前咨询中概述风险、益处和替代方案方面。
