A. J. Choudhry1, N. N. Haddad1, E. B. Habermann2, D. S. Morris1, S. F. Heller1, B. D. Kim1, D. H. Jenkins1, M. D. Zielinski1 1Mayo Clinic,General Surgery,Rochester, MN, USA 2Mayo Clinic,Robert D. And Patricia E. Kern Center For The Science Of Health Care Delivery, Surgical Outcomes Program,Rochester, MN, USA
Objective: Deemed a high risk specialty, general surgery litigation rates are rising with some of the highest malpractice premiums in the medical field. Hernia surgery is among the most common surgical procedures performed by general surgeons estimated to be 750,000 operations yearly. Our objective was to analyze malpractice litigation related to hernia surgery and discuss ways to prevent future litigation for physicians.
Methods: Using Westlaw Next (Thomson Reuters, New York, NY), a comprehensive law database with publically available records collected from many jurisdictions, we searched all jury verdicts and settlements for the terms: ‘medical malpractice’, ‘hernia’ and, ‘herniorrhaphy.’ Dates of cases ranged from 1985 to 2015. Exclusion criteria included cases where hernia surgery was not the primary reason for litigation. Information was collected from all cases on patient demographics, physician speciality, procedural characteristics, alleged reason for malpractice claim and outcome of the trial. Data is presented as means ± standard deviation with a p value of <0.05 is considered statistically significant.
Results: The search criteria yielded 568 case briefs; 260 cases met inclusion criteria and were included in the study. Sixty-five percent (170) of the patients involved in cases were male; mean patient age was 50 ± 15. The two most common hernia procedures which led to litigation were inguinal and ventral hernia repairs (>90%). The state of New York had the highest number of medical malpractice cases (47) followed closely by California (46). In 38 cases (15%) the patient claimed informed consent was breeched by the surgeon. The most common alleged reason for litigation was damage to surrounding structures. Overall 59% (152) of cases were decided in favor of the defendant (physician). Median jury verdict and settlement sum was $700,000.
Conclusion: Surgical complications and patient death played a significant role in outcomes of malpractice litigation. Although a majority of the cases were decided in the favor of the defendant, jury verdicts and settlements decided in favor of the plaintiff were costly. By understanding the reasons why surgeons go to trial; the risk of future lawsuits may lessen if proper measures are taken to prevent such outcomes.