BACKGROUND: Although commonly performed, tonsillectomy is not necessarily a low-risk procedure for litigation. We have reviewed malpractice claims involving fatal and nonfatal injuries following tonsillectomy with an emphasis on anesthesia- and opioid-related claims and their characteristics. METHODS: Tonsillectomy-related malpractice claims and jury verdict reports from the United States (US) between 1984 and 2012 found in the LexisNexis MEGA™ Jury Verdicts and Settlements database were reviewed by two independent reviewers. LexisNexis database collects nationwide surgical, anesthesia, and other malpractice claims. Data including years of case and verdicts, surgical, anesthetic and postoperative opioid-related complications, details of injury, death, cause of death, litigation result, and judgment awarded were analyzed. When there were discrepancies between the two independent reviewers, a third reviewer (SS) was involved for resolution. Inflation adjusted monetary awards were based on 2013 US dollars. RESULTS: There were 242 tonsillectomy-related claim reports of which 98 were fatal claims (40.5%) and 144 nonfatal injury claims (59.5%). Verdict/settlement information was available in 72% of cases (n = 175). The median age group of patients was 8.5 years (range 9 months to 60 years). Primary causes for fatal claims were related to surgical factors (n = 39/98, 39.8%) followed by anesthesia-related (n = 36/98, 36.7%) and opioid-related factors (n = 16/98, 16.3%). Nonfatal injury claims were related to surgical (101/144, 70.1%), anesthesia (32/144, 22.2%)- and opioid-related factors (6/144, 4.2%). Sleep apnea was recorded in 17 fatal (17.4%) and 15 nonfatal claims (10.4%). Opioid-related claims had the largest median monetary awards for both fatal ($1 625 892) and nonfatal injury ($3 484 278) claims. CONCLUSIONS: Tonsillectomy carries a high risk from a medical malpractice standpoint for the anesthesiologists and otolaryngologists. Although surgery-related claims were more common, opioids- and anesthetic-related claims were associated with larger median monetary verdicts, especially those associated with anoxic, nonfatal injuries. Caution is necessary when opioids are prescribed post-tonsillectomy, especially in patients with sleep apnea.
BACKGROUND: Although commonly performed, tonsillectomy is not necessarily a low-risk procedure for litigation. We have reviewed malpractice claims involving fatal and nonfatal injuries following tonsillectomy with an emphasis on anesthesia- and opioid-related claims and their characteristics. METHODS: Tonsillectomy-related malpractice claims and jury verdict reports from the United States (US) between 1984 and 2012 found in the LexisNexis MEGA™ Jury Verdicts and Settlements database were reviewed by two independent reviewers. LexisNexis database collects nationwide surgical, anesthesia, and other malpractice claims. Data including years of case and verdicts, surgical, anesthetic and postoperative opioid-related complications, details of injury, death, cause of death, litigation result, and judgment awarded were analyzed. When there were discrepancies between the two independent reviewers, a third reviewer (SS) was involved for resolution. Inflation adjusted monetary awards were based on 2013 US dollars. RESULTS: There were 242 tonsillectomy-related claim reports of which 98 were fatal claims (40.5%) and 144 nonfatal injury claims (59.5%). Verdict/settlement information was available in 72% of cases (n = 175). The median age group of patients was 8.5 years (range 9 months to 60 years). Primary causes for fatal claims were related to surgical factors (n = 39/98, 39.8%) followed by anesthesia-related (n = 36/98, 36.7%) and opioid-related factors (n = 16/98, 16.3%). Nonfatal injury claims were related to surgical (101/144, 70.1%), anesthesia (32/144, 22.2%)- and opioid-related factors (6/144, 4.2%). Sleep apnea was recorded in 17 fatal (17.4%) and 15 nonfatal claims (10.4%). Opioid-related claims had the largest median monetary awards for both fatal ($1 625 892) and nonfatal injury ($3 484 278) claims. CONCLUSIONS: Tonsillectomy carries a high risk from a medical malpractice standpoint for the anesthesiologists and otolaryngologists. Although surgery-related claims were more common, opioids- and anesthetic-related claims were associated with larger median monetary verdicts, especially those associated with anoxic, nonfatal injuries. Caution is necessary when opioids are prescribed post-tonsillectomy, especially in patients with sleep apnea.
Authors: Alexander Schnabel; Sylvia U Reichl; Christine Meyer-Frießem; Peter K Zahn; Esther Pogatzki-Zahn Journal: Cochrane Database Syst Rev Date: 2015-03-18
Authors: Terri Voepel-Lewis; Brian J Zikmund-Fisher; Carol J Boyd; Philip T Veliz; Sean E McCabe; Monica J Weber; Alan R Tait Journal: Clin J Pain Date: 2018-06 Impact factor: 3.442
Authors: Sherri L Katz; Andrea Monsour; Nicholas Barrowman; Lynda Hoey; Matthew Bromwich; Franco Momoli; Theodora Chan; Reuben Goldberg; Abhilasha Patel; Li Yin; Kimmo Murto Journal: J Clin Sleep Med Date: 2019-11-27 Impact factor: 4.062
Authors: Lena Xiao; Nicholas Barrowman; Franco Momoli; Kimmo Murto; Matthew Bromwich; Frédéric Proulx; Sherri L Katz Journal: J Clin Sleep Med Date: 2021-11-01 Impact factor: 4.062
Authors: Frances Chung; Stavros G Memtsoudis; Satya Krishna Ramachandran; Mahesh Nagappa; Mathias Opperer; Crispiana Cozowicz; Sara Patrawala; David Lam; Anjana Kumar; Girish P Joshi; John Fleetham; Najib Ayas; Nancy Collop; Anthony G Doufas; Matthias Eikermann; Marina Englesakis; Bhargavi Gali; Peter Gay; Adrian V Hernandez; Roop Kaw; Eric J Kezirian; Atul Malhotra; Babak Mokhlesi; Sairam Parthasarathy; Tracey Stierer; Frank Wappler; David R Hillman; Dennis Auckley Journal: Anesth Analg Date: 2016-08 Impact factor: 5.108