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Malpractice litigation in cardiac surgery: Alleged injury mechanisms and outcomes.

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  • Author(s): Eltorai AS;Eltorai AS
  • Source:
    Journal of cardiac surgery [J Card Surg] 2019 May; Vol. 34 (5), pp. 323-328. Date of Electronic Publication: 2019 Mar 24.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8908809 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8191 (Electronic) Linking ISSN: 08860440 NLM ISO Abbreviation: J Card Surg Subsets: MEDLINE
    • Publication Information:
      Publication: Hoboken, NJ : Wiley-Blackwell
      Original Publication: Mount Kisco, N.Y. : Futura Pub. Co., Inc., [c1986-
    • Subject Terms:
      Jurisprudence*; Cardiac Surgical Procedures/*legislation & jurisprudence ; Malpractice/*legislation & jurisprudence ; Malpractice/*statistics & numerical data ; Surgeons/*legislation & jurisprudence; Aged ; Cardiac Catheterization ; Coronary Artery Bypass/legislation & jurisprudence ; Female ; Heart Valves/surgery ; Humans ; Male ; Middle Aged ; Postoperative Care/legislation & jurisprudence ; Postoperative Hemorrhage
    • Abstract:
      Background and Aim: The feared prospect of involvement in malpractice litigation ultimately becomes a reality for many physicians in high-risk specialties such as cardiothoracic surgery. This study systematically analyzes malpractice claims by procedure type and alleged injury mechanism.
      Methods: An extensive nation-wide database of medical malpractice claims was searched, and 140 involving cardiac procedures were identified. The primary reason for the lawsuit was classified as a periprocedural injury, postoperative mismanagement, failure to operate in a timely manner or at all, performing an unnecessary procedure, performing a procedure too soon, lack of informed consent, or patient abandonment.
      Results: Cardiac surgeons were defendants in 47.8% of cases and cardiologists in 56.4%. Forty percent of cases involved coronary artery bypass grafting, valvular surgery, or both; 50% of these received defendant verdicts. The most common reason for the lawsuit was periprocedural injury, most frequently due to poor prosthetic valve fit/securement (23.1%) or surgical site infection (15.4%). For congenital cases, most lawsuits alleged periprocedural injury, with perfusion-related issues (cooling during circulatory arrest, failure to inform surgeon about poor oxygenation) cited in 37.5%. Cardiologists and cardiothoracic or vascular surgeons were codefendants in 14.3% of cases, most commonly coronary artery bypass grafting (40%) or cardiac catheterizations (25%). In all catheterization cases, the allegation against the surgeon was a failure to diagnose/treat the complication in a proper or timely manner. In postoperative mismanagement cases, bleeding/tamponade was the most common allegation category (31.8%).
      Conclusions: A careful review of cardiac surgical malpractice litigation can identify common contributory factors to adverse patient outcomes and catalyze practice improvement.
      (© 2019 Wiley Periodicals, Inc.)
    • Contributed Indexing:
      Keywords: cardiovascular research; quality improvement
    • Publication Date:
      Date Created: 20190325 Date Completed: 20191101 Latest Revision: 20191101
    • Publication Date:
      20250114
    • Accession Number:
      10.1111/jocs.14026
    • Accession Number:
      30905069