From Operating Room to Courtroom: Analyzing Malpractice Trajectories in Cranial Neurosurgery.

Autor:	Gerstl JVE; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Gupta S; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA.; Program for Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston , Massachusetts , USA., Stenberg CE; Simpson Thacher & Bartlett LLP, Houston , Texas , USA., Chabros J; School of Clinical Medicine, University of Cambridge, Cambridge , UK., Nonnenbroich LF; Faculty of Medicine, Heidelberg University, Heidelberg , Germany., Lindberg R; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm , Sweden., Altshuler MS; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Seaver D; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Mooney MA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Frerichs KU; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Smith TR; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA., Arnaout O; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston , Massachusetts , USA.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2025 Jan 01; Vol. 96 (1), pp. 205-212. Date of Electronic Publication: 2024 Jun 25.
DOI:	10.1227/neu.0000000000003052
Abstrakt:	Background and Objectives: Nearly all neurosurgeons in the United States will be named defendants in a malpractice claim before retirement. We perform an assessment of national malpractice trends in cranial neurosurgery to inform neurosurgeons on current outcomes, trends over time, benchmarks for malpractice coverage needs, and ways to mitigate lawsuits. Methods: The Westlaw Edge and LexisNexis databases were searched to identify medical malpractice cases relating to open cranial surgery between 1987 and 2023. Extracted data included date of verdict, jurisdiction, outcome, details of sustained injuries, and any associated award/settlement figures. Results: Of 1550 cases analyzed, 252 were identified as malpractice claims arising from open cranial surgery. The median settlement amount was $950 000 and the average plaintiff ruling was $2 750 000. The highest plaintiff ruling resulted in an award of $28.1 million. Linear regression revealed no significant relationship between year and defendant win ( P -value = .43). After adjusting for inflation, award value increased with time ( P -value = .01). The most common cranial subspecialties were tumor (67 cases, 26.6%), vascular (54 cases, 21.4%), infection (23 cases, 9.1%), and trauma (23 cases, 9.1%). Perioperative complications was the most common litigation category (96 cases, 38.1%), followed by delayed treatment (40 cases, 15.9%), failure to diagnose (38 cases, 15.1%), and incorrect choice of procedure (29 cases, 11.5%). The states with most claims were New York (40 cases, 15.9%), California (24 cases, 9.5%), Florida (21 cases, 8.3%), and Pennsylvania (20 cases, 7.9%). Conclusion: Although a stable number of cases were won by neurosurgeons, an increase in award sizes was observed in the 37-year period assessed. Perioperative complications and delayed treatment/diagnosis were key drivers of malpractice claims. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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