From the Guidelines
Surgical procedures most likely to be associated with lawsuits include thyroidectomy, neurosurgery, orthopedic surgery, general surgery, obstetrics/gynecology, and plastic/cosmetic surgery, with thyroidectomy being a significant contributor due to the high incidence of recurrent laryngeal nerve injuries, as reported in a study published in the International Journal of Surgery in 2017 1. These high-risk specialties share common factors that increase litigation risk, including high patient expectations, potential for serious complications, procedures with narrow margins for error, and outcomes that significantly impact quality of life.
- Thyroidectomy is one of the most commonly performed interventions in general surgery, and the incidence of recurrent laryngeal nerve injuries has become a major cause of surgical malpractice claims, with a median jury award of $974,625 in the United States, as reported in a study published in the International Journal of Surgery in 2017 1.
- Neurosurgical procedures carry high litigation risk due to the complexity of operating on the brain and spinal cord, where even minor errors can cause devastating permanent neurological damage.
- Orthopedic surgeries, particularly those involving the spine, joints, and complex fractures, frequently lead to lawsuits when patients experience persistent pain or functional limitations post-surgery.
- General surgical procedures like cholecystectomies and bowel resections face litigation risk from complications such as bile duct injuries or anastomotic leaks.
- In obstetrics, cesarean sections and vaginal deliveries resulting in birth injuries to mother or child are common sources of malpractice claims.
- Plastic surgery procedures, especially elective cosmetic surgeries, generate lawsuits when aesthetic outcomes don't meet patient expectations or when complications occur. The emotional and financial consequences of surgical complications often drive patients to seek legal recourse when adverse events occur, as noted in a study published in the International Journal of Surgery in 2017 1. Key factors that contribute to the high litigation risk in these specialties include:
- High patient expectations
- Potential for serious complications
- Procedures with narrow margins for error
- Outcomes that significantly impact quality of life As reported in a study published in the International Journal of Surgery in 2017, the incidence of recurrent laryngeal nerve injuries during thyroidectomy can be reduced to 0.3-3% with the use of capsular dissection, visual identification, and intraoperative nerve monitoring, but these measures do not prevent vocal cord paralysis in all cases 1.
From the Research
Surgical Procedures Associated with Lawsuits
The following surgical procedures are associated with a high risk of lawsuits:
- Neurosurgery, particularly spine surgeries 2
- Elective lumbar spinal fusion (LSF) surgery 3
- Cardiac and vascular surgeries, such as coronary artery bypass grafting and carotid endarterectomy 4, 5
Common Claims and Alleged Malpractice
Some common claims and alleged malpractice associated with these surgical procedures include:
- Intraprocedural errors (37.4% in neurosurgery, 28% in LSF) 2, 3
- Delayed diagnoses (32.1% in neurosurgery) 2
- Failure to treat (28.8% in neurosurgery) 2
- Failure to obtain informed consent (24% in LSF) 3
- Misdiagnosis or choice of incorrect procedure (18.4% in neurosurgery) 2
Regional Variations in Lawsuits
There are regional variations in the frequency and outcome of lawsuits, with the Northeast region displaying significantly higher award payouts compared to other U.S. regions 3
Surgical Approaches and Litigation Risk
Different surgical approaches may have varying risks of litigation, with anterior lumbar interbody fusion (ALIF) cases being 2.75 times more likely to be cited for excessive or inappropriate surgery compared to posterior surgical approaches 3