Litigation involving pediatric surgical conditions

J Pediatr Surg. 2020 Apr;55(4):602-608. doi: 10.1016/j.jpedsurg.2019.08.047. Epub 2019 Aug 31.

Abstract

Purpose: Malpractice litigation among pediatric surgeons is a subject of concern and interest, but minimal factual data are known. Our goal was to investigate national litigation trends regarding pediatric surgical conditions.

Methods: We queried WestlawNext database for malpractice cases involving pediatric (age ≤ 18) surgical conditions. Cases were included if they named a care provider or health center. We gathered data on diagnoses, procedures, care providers, allegations, location, and outcomes.

Results: Our search revealed 4754 cases, and 170 met inclusion criteria. These ranged from 1965 to 2017 and represented 40 states. 110 cases involved a surgeon (41% pediatric surgeons). Appendicitis was the most common diagnosis identified. Cases frequently involved delayed/missed diagnoses or interventions (45.9%), technical concerns (35.9%), mortalities (26.5%), negligent perioperative care (23.6%), and informed consent concerns (4.7%). Technical complication was the most common allegation against surgeons (49.1%), and nonsurgeon cases typically involved a delayed/missed diagnosis (78.3%). 39% of cases resulted in favor of the defendant, 35% plaintiff, and 14% had a split verdict.

Conclusion: Litigation involving pediatric surgical conditions is diverse, but appendicitis and circumcision comprise almost a third of cases. A greater understanding of these trends can help steer efforts in quality and safety as well as guide improved communication with families.

Level of evidence: N/A.

Keywords: Defendant; Litigation; Malpractice; Pediatric surgery; Plaintiff.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Appendectomy / legislation & jurisprudence
  • Child
  • Child, Preschool
  • Circumcision, Male / legislation & jurisprudence
  • Databases, Factual
  • Delayed Diagnosis
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Informed Consent
  • Male
  • Malpractice / legislation & jurisprudence*
  • Medical Errors / legislation & jurisprudence*
  • Pediatricians / legislation & jurisprudence*
  • Perioperative Care / legislation & jurisprudence*
  • Surgeons / legislation & jurisprudence*
  • Surgical Procedures, Operative / legislation & jurisprudence*
  • United States