Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
International Refugee Assistance Project, New York, USA.
Aesthet Surg J. 2021 Sep 14;41(10):1132-1138. doi: 10.1093/asj/sjaa380.
When complications following rhinoplasty occur or when the desired outcome is not achieved, patients may seek litigation on the premise that there was a violation in the standard of care. Knowledge of malpractice claims can inform rhinoplasty surgeons on how to minimize risk of future litigation as well as improve patient satisfaction.
The aims of this study were to identify motives for seeking medical malpractice litigation after rhinoplasty, and to examine outcomes of malpractice litigation after rhinoplasty in the United States.
The Westlaw legal database was reviewed for all available court decisions related to malpractice after rhinoplasty. Data collected and analyzed included plaintiff gender, location, specialty of defendant(s), plaintiff allegation, and adjudicated case outcomes.
Twenty-three cases were identified between 1960 and 2018, located in 12 US states; 70% of the plaintiffs were female. Otolaryngologists were cited in 11 cases, whereas 12 cases involved a plastic surgeon. All cases alleged negligence. Cases involved "technical" errors (69.6%), "unsatisfactory" outcomes (39.1%), inadequate follow-up or aftercare (30.4%), issues with the informed consent process (21.7%), unexpectedly extensive surgery (8.7%), improper medication administration (4.3%), and failure to recognize symptoms (4.3%). Twenty of the 23 adjudicated cases (86.9%) were ruled in favor of the surgeon. The main contributing factor in cases alleging malpractice was poor aesthetic outcome/disfigurement (60.7%).
Malpractice litigation after rhinoplasty favored the surgeon in the majority of the adjudicated cases reviewed. The principal reason for litigating was dissatisfaction with aesthetic outcomes. Rhinoplasty surgeons may mitigate possible litigation by developing a positive doctor-patient relationship, clearly understanding the patient's surgical expectations, and obtaining detailed informed consent while maintaining frequent and caring communication with the patient.
当鼻整形术后出现并发症或未达到预期效果时，患者可能会以违反护理标准为由提起诉讼。了解医疗事故索赔可以告知鼻整形外科医生如何最大程度地降低未来诉讼的风险，并提高患者满意度。
本研究旨在确定鼻整形术后寻求医疗事故诉讼的动机，并检查美国鼻整形术后医疗事故诉讼的结果。
审查了 Westlaw 法律数据库中所有与鼻整形术后医疗事故相关的可用法庭判决。收集和分析的数据包括原告性别、地点、被告专业、原告指控和判决结果。
1960 年至 2018 年期间共确定了 23 例案件，分布在 12 个美国州；70%的原告为女性。耳鼻喉科医生在 11 例中被引用，而 12 例涉及整形外科医生。所有案件均指控疏忽。涉及“技术”错误（69.6%）、“不满意”结果（39.1%）、随访或后续护理不足（30.4%）、知情同意过程问题（21.7%）、手术范围异常扩大（8.7%）、用药不当（4.3%）和未能识别症状（4.3%）。23 例裁决案件中有 20 例（86.9%）有利于外科医生。在指控医疗事故的案件中，主要因素是美学效果不佳/毁容（60.7%）。
在审查的判决案件中，鼻整形术后的医疗事故诉讼大多数对外科医生有利。提起诉讼的主要原因是对美学效果不满意。鼻整形外科医生可以通过建立积极的医患关系、清楚地了解患者的手术期望、获得详细的知情同意，并与患者保持频繁而关怀的沟通，从而减轻可能的诉讼。
