10. Do Plastic Surgery Residents Get Sued? An Analysis of Malpractice Lawsuits

Abstract

Background: Residents may be implicated in malpractice lawsuits. Our study aims to examine medical malpractice lawsuits involving plastic surgery trainees. Methods: Using the LexisNexis legal database, jury verdicts and settlements from all appellate state and federal cases between February 1988 and 2020 were queried, and a non-representative sample of over 300 cases was compiled, each of which were manually reviewed by 2 authors (A.G. and S.J.). Results: During a 30-year period, 22 malpractice cases involving plastic surgery trainees were identified. Of these cases, 15 (68.2%) involved claims in which a trainee was directly named as a defendant. A total of 18 (81.8%) cases were due to procedural-related adverse outcomes, while 4 (18.2%) cases were associated with clinical or diagnostic-related adverse outcomes. Of the procedure-related cases, 5 (27.8%) occurred when the trainee was the lead surgeon. Allegations raised by plaintiffs included lack of informed consent of procedure complications (12, 54.5%), procedural error (11, 50%), failure to supervise a trainee (11, 50%), inexperience of the trainee (8, 36.4%), incorrect diagnosis or treatment (5, 22.7%), a delay in evaluation (3 cases, 13.6%), lack of informed consent of resident being involved (3, 13.6%), lack of follow-up care (3, 13.6%), and prolonged operative time (1, 4.5%). The median time from injury to lawsuit resolution was 3.5 years (interquartile range [IQR], 3-5 years). Verdicts were ruled in favor of the defense in 9 (40.9%) cases and for the plaintiff in 6 (27.3%) cases. A settlement was made in 7 (31.8%) cases. The median payout for plaintiff-won cases was $5,100,000 (IQR $1,530,000-$17,500,000), and the median settlement was $2,500,000 (IQR $262,500-$4,410,000).?? Conclusion: Procedural error, improper informed consent, improper trainee supervision, and resident inexperience were the most common allegations proposed by patients in cases involving plastic surgery trainees. These factors can lead to an enduring financial and psychological burden early on in a physician’s career, as well as poor health outcomes. Highlighting these issues during medical education may decrease physician malpractice risk, lower the incidence of burnout, and ultimately improve patient satisfaction and outcomes.