Management of testicular torsion in the ER: lessons learned from medical professional liability claims

Abstract

ObjectiveTo evaluate emergency care for testicular torsion (TT) in medical professional liability (MPL) claims. MethodsClaims related to TT from 2000 to 2018 were located. The assistance provided and the association with MPL were analyzed. ResultsEighty complaints were identified, testicular pain was reported in 83.75% of first consultations, with a mean evolution time of 15.5 h. The mean time to diagnosis was 7.98 days. The first consultation was at the hospital in 75.1% of cases, but an ultrasound was performed only in 7.5%. When TT diagnosis was performed, 97.3% had undergone ancillary tests. The MPL was significantly associated with non-criminal proceedings and with less than 6 h of symptoms’ evolution, and, within this subgroup, without undergoing an ultrasound scan. ConclusionsLate consultations, wrong diagnosis and late diagnosis are claimed. When MPL are claimed by means of non-criminal law, the existence of responsibility is frequently considered, even more in those cases when the consultation took place before 6 h of evolution with no ancillary tests having been performed.