Literature DB >> 15912046

Trauma surgery malpractice risk: perception versus reality.

Ronald M Stewart1, Joe Johnston, Kathy Geoghegan, Tiffany Anthony, John G Myers, Daniel L Dent, Michael G Corneille, Daren S Danielson, H David Root, Basil A Pruitt, Stephen M Cohn.   

Abstract

OBJECTIVE: We set out to compare the malpractice lawsuit risk and incidence in trauma surgery, emergency surgery, and elective surgery at a single academic medical center. SUMMARY AND BACKGROUND DATA: The perceived increased malpractice risk attributed to trauma patients discourages participation in trauma call panels and may influence career choice of surgeons. When questioned, surgeons cite malpractice risk as a rationale for not providing trauma care. Little data substantiate or refute the perceived high trauma malpractice risk. We hypothesized that the malpractice risk was equivalent between an elective surgical practice and a trauma/emergency practice.
METHODS: Three prospectively maintained institutional databases were used to calculate and characterize malpractice incidence and risk: a surgical operation database, a trauma registry, and a risk management/malpractice database. Risk groups were divided into elective general surgery (ELECTIVE), urgent/emergent, nontrauma general surgery (URGENT), and trauma surgery (TRAUMA). Malpractice claims incidence was calculated by dividing the total number of filed lawsuits by the total number of operative procedures over a 12-year period.
RESULTS: Over the study period, 62,350 operations were performed. A total of 21 lawsuits were served. Seven were dismissed. Three were granted summary judgments to the defendants. Ten were settled with payments to the plaintiffs. One went to trial and resulted in a jury verdict in favor of the defendants. Total paid liability was 4.7 million dollars(391,667 dollars/year). Total legal defense costs were 1.3 million dollars(108,333 dollars/year). The ratio of lawsuits filed/operations performed and incidence in the 3 groups is as follows: ELECTIVE 14/39,080 (3.0 lawsuits/100,000 procedures/year), URGENT 5/17,958, (2.3 lawsuits/100,000 procedures/year), and TRAUMA 2/5312 (3.1/100,000 procedures/year). During the study period, there were an estimated 49,435 trauma patients evaluated. The incidence of malpractice lawsuits using this denominator is 0.34 lawsuits/100,000 patients/year.
CONCLUSIONS: These data demonstrate no increased risk of lawsuit when caring for trauma patients, and the actual risk of a malpractice lawsuit was low.

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Mesh:

Year:  2005        PMID: 15912046      PMCID: PMC1357176          DOI: 10.1097/01.sla.0000164179.48276.45

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  13 in total

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Review 6.  Risk management: extreme honesty may be the best policy.

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Journal:  Ann Intern Med       Date:  1999-12-21       Impact factor: 25.391

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9.  Will future surgeons be interested in trauma care? Results of a resident survey.

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10.  Surgical adverse events, risk management, and malpractice outcome: morbidity and mortality review is not enough.

Authors:  John A Morris; Ysela Carrillo; Judith M Jenkins; Philip W Smith; Sandy Bledsoe; James Pichert; Andrew White
Journal:  Ann Surg       Date:  2003-06       Impact factor: 12.969

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  9 in total

1.  Transparent and open discussion of errors does not increase malpractice risk in trauma patients.

Authors:  Ronald M Stewart; Michael G Corneille; Joe Johnston; Kathy Geoghegan; John G Myers; Daniel L Dent; Marilyn McFarland; Joshua Alley; Basil A Pruitt; Stephen M Cohn
Journal:  Ann Surg       Date:  2006-05       Impact factor: 12.969

2.  Professional liability in orthopaedics and traumatology in Italy.

Authors:  Umberto Tarantino; Alessio Giai Via; Ernesto Macrì; Alessandro Eramo; Valeria Marino; Luigi Tonino Marsella
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3.  Has the trauma surgeon become house staff for the surgical subspecialist?

Authors:  David J Ciesla; Ernest E Moore; C Clay Cothren; Jeffery L Johnson; Jon M Burch
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4.  Litigations in orthopedics and trauma surgery: reasons, dynamics, and profiles.

Authors:  Martin Gathen; M Jaenisch; F Fuchs; L Weinhold; M Schmid; S Koob; D C Wirtz; M D Wimmer
Journal:  Arch Orthop Trauma Surg       Date:  2021-05-27       Impact factor: 3.067

5.  Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims.

Authors:  M B Casali; A Blandino; S Del Sordo; G Vignali; S Novello; G Travaini; M Berlusconi; U Genovese
Journal:  J Orthop Traumatol       Date:  2018-07-27

6.  Claims in orthopedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis.

Authors:  Fay R K Sanders; Patricia Wimmer-Boelhouwers; Onno X Dijt; Gino M M J Kerkhoffs; Tim Schepers
Journal:  Eur J Orthop Surg Traumatol       Date:  2020-07-26

7.  Dispute cases related to pain management in Korea: analysis of Korea Medical Dispute Mediation and Arbitration Agency data.

Authors:  Ju Hwan Lee; Jaekyeong Song; Youn-Hee Kuk; Jeong-Ryang Ha; Yeon-Dong Kim
Journal:  Anesth Pain Med (Seoul)       Date:  2020-01-31

8.  Medical Malpractice Claims and Mitigation Strategies Following Spine Surgery.

Authors:  Keith L Jackson; Jacob Rumley; Matthew Griffith; Timothy R Linkous; Uzondu Agochukwu; John DeVine
Journal:  Global Spine J       Date:  2020-08-07

9.  United States level I trauma centers are not created equal - a concern for patient safety?

Authors:  Bruce H Ziran; Mary-Kate Barrette-Grischow; Barbara Hileman
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  9 in total

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