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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Investigation of litigation in trauma orthopaedic surgery
Maryam Salimi, Mohammad Bagher Heidari, Zohre Ravandi, Seyedarad Mosalamiaghili, Peyman Mirghaderi, Meisam Jafari Kafiabadi, Farsad Biglari, Amirhossein Salimi, Amir Sabaghzadeh Irani, Seyyed Saeed Khabiri
Maryam Salimi, Department of Orthopaedic Surgery, Shiraz University of Medical Sciences, Shiraz 7138433608, Iran
Mohammad Bagher Heidari, Department of General Surgery, Kermanshah University of Medical Sciences, Kermanshah 71384333608, Iran
Zohre Ravandi, Student Research Committee, Kermanshah University of Medical Sciences, Shiraz 7138438756, Iran
Seyedarad Mosalamiaghili, Student Research Committee, Shiraz University of Medical Sciences, Shiraz 716549834, Iran
Peyman Mirghaderi, Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran 714356743, Iran
Meisam Jafari Kafiabadi, Farsad Biglari, Amir Sabaghzadeh Irani, Seyyed Saeed Khabiri, Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 715643498, Iran
Amirhossein Salimi, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd 719167534, Iran
Author contributions: Khabiri SS designed and performed the research; Heidari MB and Ravandi Z designed the research and collected the data; Mosalamiaghili S and Jafari Kafiabadi M designed the research and contributed to the analysis and interpreted the result; Mirghaderi P, Biglari F, and Sabaghzadeh Irani A designed the research and drafted the manuscript; Salimi M designed the research and wrote the paper; Salimi M designed the research and edited significantly.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Kermanshah University of Medical Sciences (Approval No. IR.KUMS.REC.1399.1604).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.
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: Seyyed Saeed Khabiri, MD, Assistant Professor, Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Velenjak 7th Floor, Bldg No. 2 SBUMS, Arabi Ave, Tehran 715643498, Iran. saeed.khabiri@gmail.com
Received: October 9, 2022
Peer-review started: October 9, 2022
First decision: November 25, 2022
Revised: December 23, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 16, 2023
BACKGROUND
It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.
AIM
To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.
METHODS
A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.
RESULTS
A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively. Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.
CONCLUSION
Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.
Core Tip: Given that orthopedics is ranked as the third most dangerous medical specialty by medical indemnity insurers, an investigation into it is necessary. Many of these complaints arose from a failure to adequately inform patients of the dangers and advantages of their treatment. Surgical treatment of hand injuries was the most complaints from patients in our study. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and a technological error. The remedies to these issues are knowledge, practical surgical expertise, and behavioral education.
