Nguyen Kai, Vyhmeister Ethan, Brandt Zachary, Essilfie Anthony
From the School of Medicine, Loma Linda University, Loma Linda, CA (Nguyen, Vyhmeister, Brandt), and the Department of Orthopedics, Kaiser Permanente, Panorama City, CA (Essilfie).
J Am Acad Orthop Surg. 2025 Jul 31. doi: 10.5435/JAAOS-D-24-01487.
The primary aim of this study was to identify and characterize medical malpractice lawsuits following arthroscopic surgery.
Two large medicolegal databases-Westlaw Edge and VerdictSearch-were queried using the term "arthroscopy." Cases were reviewed and classified according to the nature of the plaintiff's complaint. Cases were only included if the primary basis of litigation rested on a malpractice claim related to arthroscopy. Data collected included reason for litigation, verdict ruling, location, monetary award, and joint involved. Pearson chi-squared test was used to assess associations between the variables.
After review of 11,006 cases, 271 were identified as malpractice claims following arthroscopy. The most common reasons for litigation were perioperative complications (n = 120), delayed or denied treatment (n = 70), poor postoperative management (n = 32), inadequate informed consent (n = 22), contraindicated procedure (n = 19), and gross negligence (n = 8). More than 90% of the identified cases involved arthroscopy of the knee or shoulder, with cases involving the shoulder significantly more likely to result in a plaintiff verdict or settlement than a defendant verdict compared with cases involving the knee (P = 0.013). Regarding the verdict ruling, 71.8% (n = 140) of cases ruled in favor of the defendant, 17.9% (n = 35) ruled in favor of the plaintiff, 0.5% (n = 1) resulted in a mixed ruling, and 9.8% (n = 19) resulted in an out-of-court settlement. An average payment of $842,834 ± $958,549 resulted from cases that resulted in either a plaintiff ruling or out-of-court settlement.
This study describes several common reasons for malpractice lawsuits following arthroscopy. The study findings suggest that timeliness of diagnosis and surgical referral, coordination of care, and understanding of the indications versus limitations of conservative therapy are key factors frequently implicated in malpractice lawsuits following arthroscopic surgery.
本研究的主要目的是识别和描述关节镜手术后的医疗事故诉讼。
使用术语“关节镜检查”查询两个大型法医学数据库——Westlaw Edge和VerdictSearch。根据原告投诉的性质对案件进行审查和分类。仅当诉讼的主要依据是与关节镜检查相关的医疗事故索赔时,案件才被纳入。收集的数据包括诉讼原因、裁决结果、地点、金钱赔偿以及涉及的关节。使用Pearson卡方检验评估变量之间的关联。
在审查了11006个案件后,271个被确定为关节镜检查后的医疗事故索赔。最常见的诉讼原因是围手术期并发症(n = 120)、延迟或拒绝治疗(n = 70)、术后管理不善(n = 32)、知情同意不足(n = 22)、禁忌手术(n = 19)和严重疏忽(n = 8)。超过90%的已识别案件涉及膝关节或肩关节的关节镜检查,与涉及膝关节的案件相比,涉及肩关节的案件导致原告胜诉或和解的可能性明显高于被告胜诉(P = 0.013)。关于裁决结果,71.8%(n = 140)的案件判定被告胜诉,17.9%(n = 35)判定原告胜诉,0.5%(n = 1)导致混合裁决,9.8%(n = 19)导致庭外和解。导致原告胜诉或庭外和解的案件平均赔偿额为842834美元±958549美元。
本研究描述了关节镜检查后医疗事故诉讼的几个常见原因。研究结果表明,诊断和手术转诊的及时性、护理协调以及对保守治疗适应症与局限性的理解是关节镜手术后医疗事故诉讼中经常涉及的关键因素。