Henning Dralle1, Kerstin Lorenz, Andreas Machens. 1. Department of General, Visceral and Vascular Surgery, University Hospital and Medical Faculty, University of Halle-Wittenberg, Halle/Saale, Germany. henning.dralle@uk-halle.de
Abstract
BACKGROUND: Few investigations have addressed malpractice litigation after thyroid surgery. The purpose of this medico-legal review was to provide a more comprehensive picture of medico-legal trends in thyroid surgery. METHODS: Reviewed were all expert opinions on claims of malpractice after thyroid surgery, commissioned between 1995 and 2010 at 1 tertiary center, and their corresponding verdicts. RESULTS: Forty-three of 75 malpractice claims involved recurrent laryngeal nerve (RLN) palsy (21 unilateral and 22 bilateral palsies), with a 45% tracheostomy rate for bilateral RLN palsy. Twenty-one claims concerned permanent hypoparathyroidism. Since 2007, intraoperative nerve monitoring (IONM) has become the subject of pleading in 4 of 7 malpractice claims involving unilateral or bilateral RLN palsy. In none of these cases did IONM follow international standards, resulting in 3 plaintiff verdicts. CONCLUSION: The growing appreciation that standardized IONM can prevent bilateral RLN palsies after signal loss on the initial side of resection may become increasingly relevant to malpractice litigation.
BACKGROUND: Few investigations have addressed malpractice litigation after thyroid surgery. The purpose of this medico-legal review was to provide a more comprehensive picture of medico-legal trends in thyroid surgery. METHODS: Reviewed were all expert opinions on claims of malpractice after thyroid surgery, commissioned between 1995 and 2010 at 1 tertiary center, and their corresponding verdicts. RESULTS: Forty-three of 75 malpractice claims involved recurrent laryngeal nerve (RLN) palsy (21 unilateral and 22 bilateral palsies), with a 45% tracheostomy rate for bilateral RLN palsy. Twenty-one claims concerned permanent hypoparathyroidism. Since 2007, intraoperative nerve monitoring (IONM) has become the subject of pleading in 4 of 7 malpractice claims involving unilateral or bilateral RLN palsy. In none of these cases did IONM follow international standards, resulting in 3 plaintiff verdicts. CONCLUSION: The growing appreciation that standardized IONM can prevent bilateral RLN palsies after signal loss on the initial side of resection may become increasingly relevant to malpractice litigation.
Authors: H Dralle; K Lorenz; P Schabram; T J Musholt; C Dotzenrath; P E Goretzki; J Kußmann; B Niederle; C Nies; J Schabram; C Scheuba; D Simon; T Steinmüller; A Trupka Journal: Chirurg Date: 2013-12 Impact factor: 0.955
Authors: Magnus Melin; Katharina Schwarz; Marc D Pearson; Bernhard J Lammers; Peter E Goretzki Journal: World J Surg Date: 2014-10 Impact factor: 3.352
Authors: Melanie A McWade; Constantine Paras; Lisa M White; John E Phay; Carmen C Solórzano; James T Broome; Anita Mahadevan-Jansen Journal: J Clin Endocrinol Metab Date: 2014-12 Impact factor: 5.958