University of Washington Department of Emergency Medicine, Seattle, Washington.
Schroeter Goldmark & Bender Law Firm, Seattle, Washington.
Am J Rhinol Allergy. 2021 Nov;35(6):840-845. doi: 10.1177/19458924211004052. Epub 2021 Mar 15.
Despite studies showing most patients significantly improve their nasal congestion with surgical management of nasal turbinates, not all achieve acceptable results. Rarely, patients report substantial worsening of symptoms leading to litigation risk.
Document the United States medicolegal environment for nasal turbinate surgery.
We searched the Westlaw database for turbinate related terms for 1987- July 2019, recording demographics, claims, legal arguments, and outcomes in legal cases related to nasal turbinate surgery. We assessed prevalence and correlations with case outcomes.
Of the 39 cases identified, the most common complaint was nose/facial pain (53.8% of cases). Surgeons prevailed in 87.2% of cases, with total liabilities of $3,224,606 [mean $97,715.3, ±$283,900.8]. Surgeons had statistically significant favorable outcomes when patients claimed dryness, headache, congestion, crusting, breathing problems, and disfigurement (all p < 0.05). Revision surgery was indicated in 23.1% of cases and was claimed in 40.0% of patient awards. Surgical negligence was claimed in 40.0% of patient awards versus 67.9% of surgeon awards (p = 0.333). Lack of informed consent was claimed in 20.0% of patient awards versus 32.1% of surgeon awards (p = 0.601).
There are inherent litigation risks for surgeons when performing nasal turbinate surgery. Most claims against surgeons, are resolved in favor of the surgeon. Understanding the types of claims and legal arguments that are made by patients could help assessing the risks of a proposed litigation. Documenting clear indications for surgery and written informed consent may reduce litigations against surgeons.
尽管有研究表明，大多数患者通过鼻甲手术治疗可显著改善鼻塞症状，但并非所有患者都能获得满意的效果。极少数患者报告症状显著恶化，导致法律诉讼风险。
记录美国鼻甲手术的法医学环境。
我们在 Westlaw 数据库中搜索了 1987 年至 2019 年 7 月与鼻甲相关的术语，记录了与鼻甲手术相关的法律案件中的人口统计学数据、诉求、法律论点和结果。我们评估了这些案件的发生率及其与案件结果的相关性。
在确定的 39 个案例中，最常见的投诉是鼻/面部疼痛（53.8%的案例）。87.2%的案例中外科医生胜诉，总赔偿额为 3224606 美元[平均 97715.3 美元，±283900.8 美元]。当患者声称出现干燥、头痛、鼻塞、结痂、呼吸问题和畸形时，外科医生的结果具有统计学意义上的优势（均 p<0.05）。23.1%的案例需要进行修正手术，其中 40.0%的患者获得了赔偿。40.0%的患者赔偿中声称外科医生存在手术疏忽，而 67.9%的外科医生赔偿中声称患者缺乏知情同意（p=0.333）。20.0%的患者赔偿中声称患者缺乏知情同意，而 32.1%的外科医生赔偿中声称外科医生存在手术疏忽（p=0.601）。
外科医生行鼻甲手术时存在固有的法律诉讼风险。大多数针对外科医生的诉求都以有利于外科医生的方式解决。了解患者提出的诉求类型和法律论点，可以帮助评估拟议诉讼的风险。记录明确的手术适应证和书面知情同意书可能会减少对外科医生的诉讼。
