Indiana Hand to Shoulder Center, Indianapolis, USA.
Cleveland Clinic Foundation, OH, USA.
Hand (N Y). 2022 Nov;17(6):1214-1218. doi: 10.1177/1558944721998007. Epub 2021 Mar 14.
The circumstances surrounding claims against hand surgeons have not been elucidated in the literature. The purpose of this study was to analyze trends in malpractice litigation regarding hand surgery through a nationwide legal database.
The Westlaw legal research database was queried for verdicts and settlements between 1985 and 2017 for hand surgery-related malpractice cases. Cases were included if the hand surgeon was sued for malpractice. Procedure type and complications and/or adverse events that resulted in litigation were recorded. Patient characteristics, state, date of case, case outcomes, and indemnity payment were also noted. All dollar amounts were adjusted to 2017 values using the Consumer Price Index.
In all, 171 cases (35 states) were included. The most frequently litigated surgeries were carpal tunnel releases followed by fracture treatment. Nerve injury was the predominant cause of litigation. The median nerve was predominantly injured, followed by the ulnar and radial nerves. In fracture surgery, malunion was the predominant cause, followed by weakness, nerve injury, and infection. In total, 72.5% of cases yielded verdicts in favor of the defense, 21.6% favored the plaintiff, and 5.9% were settled. Indemnity varied between $7800 and $8.99 million, averaging $570,397 for cases when the jury ruled in favor of the plaintiffs. Settled cases averaged $1,140,527.
Malpractice litigation has substantial financial implications on surgeons and the health care system. Litigation arises most commonly from routine procedures (carpal tunnel release and fracture fixation) rather than complex surgical cases, potentially due to the high variability in operating surgeon subspecialization, with discrepant training.
有关手部外科医生的索赔情况在文献中尚未阐明。本研究的目的是通过全国性的法律数据库分析手部外科手术医疗事故诉讼的趋势。
在 1985 年至 2017 年期间，通过 Westlaw 法律研究数据库查询与手部外科手术相关的医疗事故诉讼的判决和和解案例。如果手部外科医生因医疗事故被起诉，则将案件包括在内。记录手术类型以及导致诉讼的并发症和/或不良事件。还记录了患者特征、州、案件日期、案件结果和赔偿支付情况。所有金额均使用消费者价格指数调整为 2017 年的价值。
总共包括 171 例（35 个州）。诉讼最频繁的手术是腕管松解术，其次是骨折治疗。神经损伤是诉讼的主要原因。正中神经受伤最常见，其次是尺神经和桡神经。在骨折手术中，畸形愈合是主要原因，其次是无力、神经损伤和感染。总的来说，72.5%的案件判决有利于辩方，21.6%有利于原告，5.9%和解。赔偿金额在 7800 美元至 8990 万美元之间，陪审团判决有利于原告的案件平均赔偿额为 570397 美元。和解案件的平均赔偿额为 1140527 美元。
医疗事故诉讼对外科医生和医疗保健系统具有重大的财务影响。诉讼最常见的是常规手术（腕管松解术和骨折固定术），而不是复杂的手术病例，这可能是由于手术医生亚专科的高度变异性，培训不一致所致。
