scholarly journals Damned if you monitor, damned if you don’t: medical malpractice and intraoperative neuromonitoring for spinal surgery

2020 ◽  
Vol 49 (5) ◽  
pp. E19
Author(s):  
Jeffrey Hatef ◽  
Miki Katzir ◽  
Nathaniel Toop ◽  
Monica Islam ◽  
Trevor Clark ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Spinal Surgery ◽  
Medical Malpractice ◽  
Standard Of Care ◽  
Intraoperative Neuromonitoring ◽  
Legal Research ◽  
Malpractice Litigation ◽  
Damage Award ◽  
Orthopedic Surgeons ◽  
Research Service

OBJECTIVEThe aim of this study was to identify trends in medical malpractice litigation related to intraoperative neuromonitoring.METHODSThe Westlaw Edge legal research service was queried for malpractice litigation related to neuromonitoring in spine surgery. Cases were reviewed to determine if the plaintiff’s assertion of negligence was due to either failure to use neuromonitoring or negligent monitoring. Comparative statistics and a detailed qualitative analysis of the resulting cases were performed.RESULTSTwenty-six cases related to neuromonitoring were identified. Spinal fusion was the procedure in question in all cases, and defendants were nearly evenly divided between orthopedic surgeons and neurosurgeons. Defense verdicts were most common (54%), followed by settlements (27%) and plaintiff verdicts (19%). Settlements resulted in a mean $7,575,000 damage award, while plaintiff verdicts resulted in a mean $4,180,213 damage award. The basis for litigation was failure to monitor in 54% of the cases and negligent monitoring in 46%. There were no significant differences in case outcomes between the two allegations of negligence.CONCLUSIONSThe use and interpretation of intraoperative neuromonitoring findings can be the basis for a medical malpractice litigation. Spine surgeons can face malpractice risks by not monitoring when required by the standard of care and by interpreting or reacting to neuromonitoring findings inappropriately.

Medicolegal Issues in Pathology

2008 ◽  
Vol 132 (2) ◽  
pp. 186-191
Author(s):  
Timothy Craig Allen
Keyword(s):  
Medical Records ◽  
Medical Malpractice ◽  
Expert Witness ◽  
Standard Of Care ◽  
Tort Law ◽  
Malpractice Litigation ◽  
Litigation Process ◽  
Risk Managers ◽  
Medicolegal Issues

Abstract The various methods used by risk managers to assist clinicians in handling medicolegal risk, including improving communication with patients and better dealing with medical records issues, are not particularly of benefit to pathologists. An understanding of tort law, the theory of negligence, the principle of standard of care, and the role of the expert witness helps the pathologist generally assess and manage risk and put it into context with daily pathology practice. An understanding of the litigation process and techniques to better handle a deposition and high-risk specimens or diagnoses are of practical value in avoiding a lawsuit or increasing the likelihood for good outcome in medical malpractice litigation.

319 Determining the Role of Informed Consent Allegations in Spinal Surgery Medical Malpractice

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 269-269
Author(s):  
Jennifer Grauberger ◽  
Panagiotis Kerezoudis ◽  
Asad Choudhry ◽  
Mohammed Ali Alvi ◽  
Sandy Goncalves ◽  
...  
Keyword(s):  
Informed Consent ◽  
Spinal Surgery ◽  
Medical Malpractice ◽  
Bivariate Analysis ◽  
Control Group ◽  
Malpractice Litigation ◽  
Additional Surgery ◽  
Increased Risk ◽  
Malpractice Claims ◽  
Severity Of Injury

Abstract INTRODUCTION Predictive factors associated with increased risk of medical malpractice litigation have been identified including severity of injury, physician sex and error in diagnosis. However, there is a paucity of literature investigating informed consent in spinal surgery malpractice. Our objective was to highlight the failure to obtain informed consent as an allegation in medical malpractice claims for patients undergoing spine-surgery. METHODS This was a retrospective case-control study using a national medico-legal database westlaw next. We identified a total of 233 patients (80 with no informed consent allegation, 153 who cited lack of informed consent) who underwent spinal surgery and filed a malpractice claim were studied. RESULTS >The most common informed consent allegations were failure to explain risks/side effects of surgery (30.4%) and failure to explain alternative treatment options (9.9%). In bivariate analysis, patients in the control group were more likely to require additional surgery (56.3% vs 34.6%, P = 0.002) and suffer from more permanent injuries compared to the informed consent group (P = 0.033). On multivariable regression analysis, permanent injuries were more often associated with indemnity payment following a plaintiff verdict (OR 3.12, 95% CI 1.46 - 6.65, P = 0.003) or a settlement (OR 6.26, 95% CI 1.06 - 36.70, P = 0.042). Informed consent allegations were significantly associated with less severe (temporary/emotional) injury (OR 0.52, 95% CI 0.28 - 0.97, P = 0.043). Additionally, allegations of informed consent were found to be predictive of a defense verdict versus a plaintiff ruling (OR 0.41, 95% CI 0.17 - 0.98, P = 0.046) or settlement (OR 0.01, 95% CI 0.001 - 0.15, P < 0.001). CONCLUSION Lack of informed consent is an important cause for medical malpractice litigation. Although associated with a lower rate of indemnity payments, malpractice lawsuits including informed consent allegations still present a time, money, and reputation toll for physicians

Standard of care and liability in medical malpractice litigation in Japan

Health Policy ◽  
2003 ◽  
Vol 65 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Akihito Hagihara ◽  
Minako Nishi ◽  
Koichi Nobutomo
Keyword(s):  
Medical Malpractice ◽  
Standard Of Care ◽  
Malpractice Litigation

Practice Guidelines

1998 ◽  
Vol 15 (1) ◽  
pp. 57-62
Author(s):  
Melvin A. Shiffman
Keyword(s):  
Practice Guidelines ◽  
Cost Containment ◽  
Medical Malpractice ◽  
Medical Literature ◽  
Standard Of Care ◽  
Malpractice Litigation

Developing clearly written, scientifically valid, and flexible practice guidelines can aid in cost containment and in the resolution of medical malpractice litigation. Practice guidelines should keep in mind both clinicians and patients and should focus on specific clinical circumstances. Deviation from the guidelines should be supported by peer-reviewed medical literature. These guidelines, if properly researched and prepared, may serve as the standard of care.

Sign in / Sign up

Export Citation Format

Share Document