Beyond the Operating Room

Abstract

PURPOSE: The cost of medical malpractice falls on both providers and consumers of healthcare. In this study we examine litigation in body contouring procedures and identify case characteristics that influence medical malpractice litigation outcomes. METHODS: The Westlaw database was searched for jury verdict and settlement reports related to medical malpractice and body contouring procedures. Cases included for analysis were examined for year, geographic location, patient demographics, procedure performed, alleged injury, causes of action, verdict, and indemnity payments. RESULTS: Our search produced 113 cases that ranged from years 1990 to 2012. California (n = 32), New York (n=16), and Florida (n=16) experienced the greatest number of cases. The majority of plaintiffs were female (93.8%) and the majority of defendants were male (96.9%). The most common injury sustained was disfigurement (n=38, 33.6%). The most common cause of action cited was negligence (n=95, 84.1%). Seventy-two cases (63.7%) resulted in favor of the defendant, 33 (29.2%) cases resulted in damages awarded, and 8 (7.1%) cases resulted in settlements (Figure 1). Median plaintiff ages between cases favoring defendant versus plaintiff differed significantly (p=0.0034) with median ages of 45 and 36 respectively (Figure 2). No significant difference was found between the median indemnity payments awarded to plaintiffs ($391,000) and settlements ($276,000).Figure 1: Figure 1.Figure 2: Figure 2.Of the alleged injuries, those cases that cited an iatrogenic injury (bowel perforation, electrocautery burns, etc.) were 2.5 times more likely to result in either damages awarded or settlement (RR = 2.5, 95% CI 1.66-3.80). Cases that cited disfigurement were 87% more likely to result in damages awarded to the plaintiff (RR = 1.87, 95% CI 1.08-3.26). Conversely, cases that cited scarring were 52% less likely to result in resolution favoring plaintiff (RR=0.48, 95% CI 0.24-0.97). Cases that cited informed consent were 50% less likely to result in resolution favoring plaintiff (RR = 0.50, CI 0.26-0.97). CONCLUSION: Based on this study, younger plaintiff age and iatrogenic injury strongly favor plaintiffs. Disfigurement favors plaintiffs only in awarded damages. Our study emphasizes the need for adequate communication with the patient regarding realistic aesthetic results and risks of the procedure. In addition, iatrogenic organ injury must be handled expeditiously. Incorporating these recommendations into clinical practice may encourage an improved physician-patient relationship while reducing healthcare costs incurred by litigation.