Dissecting malpractice in pancreaticoduodenectomy cases

• Published in: The Journal of surgical research Vol. 212; pp. 48 - 53
• Main Authors: Anandalwar, Seema P., MD, Scholer, Anthony J., MD, MBS, Ninan, Gigio, JD, Oliver, Joseph B., MD, MPH, Christian, Derick, MD, Eloy, Jean Anderson, MD, FACS, Chokshi, Ravi J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15-05-2017
• Subjects: Databases, Factual; Defendant; Diagnostic Errors - legislation & jurisprudence; Diagnostic Errors - statistics & numerical data; Expert witnesses; Humans; Litigation; Malpractice; Malpractice - economics; Malpractice - legislation & jurisprudence; Malpractice - statistics & numerical data; Medical malpractice; Misdiagnosis; Pancreaticoduodenectomy - legislation & jurisprudence; Pancreatocoduodenectomy; Plaintiff; Settlement; Specialties, Surgical - economics; Specialties, Surgical - legislation & jurisprudence; Specialties, Surgical - statistics & numerical data; Surgery; United States; Unnecessary Procedures - statistics & numerical data; Verdict; Plaintiff; Settlement; Medical malpractice; Malpractice; Litigation; Expert witnesses; Defendant; Pancreatocoduodenectomy; Misdiagnosis; Verdict
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2016.12.029

Abstract Background Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. Methods The Westlaw database was searched for jury verdicts and settlements using the terms “medical malpractice” and “pancreaticoduodenectomy”. Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. Results Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). Conclusions The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed.