Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States

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• 作者：Rounak B. Rawal^a ; ^{rrawal@unch.unc.edu" class="auth_mail" title="E-mail the corresponding author} ; Lauren A. Kilpatrick^a ; ^{lauren_kilpatrick@med.unc.edu" class="auth_mail" title="E-mail the corresponding author} ; Jeyhan S. Wood^b ; ^{jeyhan_wood@med.unc.edu" class="auth_mail" title="E-mail the corresponding author} ; Amelia F. Drake^a ; ^{amelia_drake@unc.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Malpractice ; Litigation ; Craniofacial ; Cleft
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：90
• 期：Complete
• 页码：214-219
• 全文大小：880 K

文摘

To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities.

Methods and materials

A modified Delphi approach was used to gather search terms. Search settings included “all jury verdicts and settlements”, with jurisdiction of “all states” and “all federal courts” (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice.

Results

Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). “Missed diagnosis” was the most common type of negligent claim (45%), followed by “surgical error” (21%), and “medication error” (17%). “Anoxic brain injury” resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by “wrongful birth” ($1.03 million), and “minor physical injury” ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058).

Conclusions

Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions.