Medical Malpractice Litigation Following Arthroscopic Surgery

Abstract

Purpose: Our study aims to analyze a variety of factors involving malpractice lawsuits following arthroscopy, focusing on reasons for lawsuit and establishing predictors for the outcome of the lawsuit.

Methods: Two legal databases, VerdictSearch and Westlaw, were queried for arthroscopic cases in adult patients. For all included cases, clinical and demographic data were recorded. The effects of plaintiff demographics, joint involved, lawsuit allegation, case ruling, and size of indemnity payments were assessed.

Results: Of the 240 included cases, 62 (26%) resulted in plaintiff verdict, 160 (67%) resulted in defense verdict, and 18 (8%) were settled without trial. Plaintiff demographics (age and sex) had no effect on the case ruling. There was no statistical difference between indemnity awards for plaintiff verdicts ($1,013,494) and settled cases ($848,331; P = .13). Patient death was noted in 20 cases (8.3%); a significantly higher proportion of these cases were settled versus went to trial (P = .0022), including 19 patients (95%) who had knee arthroscopy and 16 deaths (80%) resulting from a pulmonary embolus. Plaintiff verdict or settlement were seen significantly more frequently for vascular complications and wrong-sided surgery. Alternatively, defense verdicts followed lawsuits alleging surgeon technical error. Wrong-sided surgery, retained instruments, deep venous thrombosis, and postoperative infections were seen at a significantly higher proportion after knee arthroscopy than after arthroscopy of other joints. Similarly, neurological injury was significantly associated with elbow and hip arthroscopy, while allegations of technical error by the surgeon and block-related complications were associated with shoulder arthroscopy.

Conclusions: Plaintiff verdict or settlement were seen for vascular complications and wrong-sided surgery, while defense verdicts followed lawsuits alleging surgeon technical error and block-related complications. We also identified types of allegations that were associated with arthroscopy of different joints. All but one case of patient death (20 cases) were noted to involve knee arthroscopy, and an overwhelming majority resulted due to a pulmonary embolism. This information helps the arthroscopic surgeon better counsel patients and employ strategies to mitigate preventable complications.

Level of evidence: Level IV, case series.