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Journal Article

Citation

Quigley RS, Akpolat YT, Forrest BD, Wongworawat MD, Cheng WK. Spine 2015; 40(11): 851-855.

Affiliation

Robert S. Quigley, MD, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California Yusuf T. Akpolat, MD, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California Capt. Brent D. Forrest, MD, United States Air Force, Moody AFB, Georgia Montri D. Wongworawat, MD, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California Wayne K. Cheng MD, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0000000000000878

PMID

25768691

Abstract

STUDY DESIGN: Retrospective cohort study.

OBJECTIVES. To review past cases and analyze them to determine if reason for lawsuit led to a defense vs. plaintiff verdict when patients sustain spinal cord injury. Secondary objectives included analyzing demographic factors and monetary awards for plaintiff verdicts and settlements.

SUMMARY OF BACKGROUND DATA: Evaluating malpractice cases could provide valuable information for the physician who has been sued by a patient. Previous studies about litigation and spine have been focused on medical tort reform, not on the reasons for litigation and lawsuit outcome.

METHODS: A large national medico-legal research service for civil and criminal court called VerdictSearch was queried for "spinal cord injury" between the years 2000-2010. Reason for lawsuit separated into two groups, error in diagnosis (n = 48) and error in treatment (n = 25). The anatomical region, outcome, cost, and job for sued healthcare workers recorded for each lawsuit.

RESULTS: Compared with physicians who were sued for errors in diagnosis, those sued for an error of treatment had a RR of 2.69 [95% CI 1.40, 5.16] to receive a defense verdict, p = 0.003. There were no significant differences demographic information, including age, sex, occupation type, and level of injury. Among specialties, surgeons had the highest number of suits. The median value for each anatomic area was highest in thoracic spine ($1.90M), followed by cervical spine ($1.80M), and lumbar spine (0.750M), although there were no statistical differences between the three areas (p = 0.301). The median monetary award for a plaintiff verdict was higher than for a settlement ($2.90M, IQR: 1.50-12.5M versus $1.45M, IQR: 1.00-2.90M, p = 0.008).

CONCLUSIONS: Physicians are more likely to successfully defend a lawsuit for an error in treatment than for an error in diagnosis. The key to increase the success of defending a lawsuit in regards to SCI is to avoid delayed and incorrect diagnosis.


Language: en

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