Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. Sep 27, 2022; 9(1): 1-11
Published online Sep 27, 2022. doi: 10.5319/wjo.v9.i1.1
Medical malpractice litigation involving otolaryngology residents and fellows: A case-based 30-year review
Neeraj V Suresh, Viraj N Shah, Christian G Fritz, Jessica R Griff, Shreni Shah, Arjun Watane, Ravi S Parikh, Elizabeth A Nicolli
Neeraj V Suresh, Christian G Fritz, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19107, United States
Viraj N Shah, Jessica R Griff, Elizabeth A Nicolli, Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, United States
Shreni Shah, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, United States
Arjun Watane, Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT 06510, United States
Ravi S Parikh, Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY 10016, United States
Author contributions: Suresh NV, Shah VN, and Fritz CG designed the research study; Griff JR, Shah S, Watane A and Parikh RS performed the research; Suresh NV and Fritz CG analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: This study was exempted.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Christian G Fritz, BSc, Research Fellow, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 800 Walnut Street, Philadelphia, PA 19107, United States. christian.g.fritz@gmail.com
Received: June 11, 2022
Peer-review started: June 11, 2022
First decision: June 27, 2022
Revised: July 9, 2022
Accepted: August 16, 2022
Article in press: August 16, 2022
Published online: September 27, 2022
Abstract
BACKGROUND

Errors, misdiagnoses, and complications can occur while trainees are involved in patient care. Analysis of such events could reveal areas for improvement by residency and fellowship programs.

AIM

To examine lawsuits tried at the state and federal level involving otolaryngology trainees.

METHODS

The LexisNexis database, an online legal research database containing state and federal case records from across the United States, was retrospectively reviewed for malpractice cases involving otolaryngology residents or fellows from January 1, 1990 to December 31, 2020. Case data collected: Plaintiff/trainee/defendant characteristics, allegations, medical outcomes, and legal outcomes.

RESULTS

Over the study period, 20 malpractice lawsuits involving otolaryngology trainees were identified. Plaintiffs raised numerous allegations including procedural error (n = 12, 25.5%), incorrect diagnosis and/or treatment (n = 8, 17.0%), and lack of knowledge of trainee involvement (n = 6, 12.8%). Nine cases (45%) had verdicts in favor of the plaintiff, whereas 5 cases (25%) had verdicts in favor of the defense. Six cases (30%) ended in a settlement. Awards to plaintiffs were heterogenous, with a median of $617,500 (range $32K-17M) for settled cases and verdicts favoring plaintiffs.

CONCLUSION

The findings enclosed herein represent the first published analysis of trainee involvement in otolaryngology malpractice cases held at the state/federal level. Otolaryngology trainees can be involved in lawsuits for both procedural and nonprocedural events. This study highlights the importance of education specifically in the domains of procedural errors, informed consent, proper diagnosis/management, and clear communication within patient care teams. Training programs should incorporate these study findings into effective simulation courses and didactic sessions. Educating trainees about common pitfalls holds the promise of decreasing healthcare systems costs, reducing trainee burnout, and, most importantly, benefiting patients.

Keywords: Malpractice, Otolaryngology, Education, Trainees, Litigation, Quality improvement

Core Tip: Prior reports indicate that surgeons will face at least one malpractice lawsuit during their career. Malpractice suits and the threat thereof may pose a significant psychological burden on young otolaryngologists. Preparation for such a situation should be embedded into residency curricula, yet no prior study has reported on the topic of otolaryngology trainee litigation on a state/federal level. The reported cases highlight the importance of thorough informed consent, proper diagnosis/management, and clear communication between attending physicians and trainees. Incorporating these seminal cases into the existing literature would support preemptive educational efforts and provide evidence-based insight for trainees in a legal predicament.