Neurosurgery resident Department of Neurological Surgery, University of Utah, Salt Lake City, UT, USA Salt Lake City, UT, US
Disclosure(s):
Justin K. Zhang, MD, MSCI: No financial relationships to disclose
Introduction: Since the National Quality Forum published the “Never Events” list in 2002, the national exposure of wrong-sided surgeries and the associated malpractice claims has grown. Despite increasing awareness of these events and malpractice education, no study to date has comprehensively investigated the litigation associated with wrong-sided procedures in neurosurgery. This study aims to examine and characterize the malpractice claims concerning wrong-sided neurosurgery to provide neurosurgeons with a basic knowledge of medical malpractice law and assist them with best mitigating, preventing, or approaching these “Never Events.”
Methods: A retrospective review of malpractice claims involving wrong-sided neurological cases was conducted utilizing WestLaw and LexisNexis legal databases and grey literature. Clinical and legal characteristics were collected including patient age, practice setting, surgical details, court dates, case outcome, awarded damages, and any other legal claims. All characteristics were compared using independent samples t-test, chi-square goodness of fit, or chi-square test of independence.
Results: Of the initial 283 screened cases, 28 met the final inclusion criteria. Of known outcomes (19, 68%), 16 (84%) resulted in a plaintiff finding, while most claims involved wrong-sided cranial surgery (21, 75%). Three defendant outcomes were found, all of which were based on technical grounds. Among all known plaintiff outcomes with a payout (11, 44%), the median, inflation-adjusted award payout was $603,502.40 (range: $23,394.47-$37,298,104.26), with the largest median payouts being patients under 18 years old ($11,250,000). There were no significant differences in the 20 years before and after the institution of the Universal Protocol or any award payout comparison. Statistical significance was found within the numerical occurrences of final outcome, defendant type, surgical location, and cranial pathology compared to established literature.
Conclusion : This descriptive analysis provides much-needed insight into the multifaceted characteristics of wrong-sided malpractice litigation and provides an understanding of the circumstances involving wrong-sided surgery.
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