Plaintiff Awards Research Articles

A Retrospective Analysis of Urethroplasty and Medical Malpractice

ObjectivesTo review malpractice suits stemming from urethroplasty intervention, which is the standard of care for patients suffering from urethral strictures. MethodsThis retrospective study analyzed the LexisNexis and Westlaw databases between 1980 and 2024. Each database was queried with “urethroplasty” which yielded 48 cases and 20 jury verdicts/settlements in the LexisNexis database and 46 cases and 14 jury verdicts in the Westlaw database. Selected cases were reviewed variables including chief allegation, litigation location, plaintiff demand, plaintiff award, and verdict. Exclusion criteria included but were not limited to lawsuits regarding non-urologic surgery necessitating urethroplasty and litigation based on traumatic injury necessitating urethroplasty. ResultsAfter manual review of 128 cases in the LexisNexis and Westlaw databases, 12 met inclusion criteria. 5 (42%) cases sued for deformation of the genitalia after urethroplasty, 2 (17%) sued for failure of informed consent, 2 (17%) sued for erectile dysfunction, 1 (8%) sued for a post-operative venous thrombosis, 1 (8%) sued for post-operative infection, and 1 (8%) sued for failure to treat. 6 (50%) cases resulted in plaintiff awards; 3 of these were settled before a final verdict. Plaintiff awards varied from $72,500 - $810,000. Of the twelve cases, 2 (17%) occurred in California and 2 (17%) occurred in Illinois; the remaining locations were isolated. ConclusionsThe most common cause of litigation following urethroplasty was centered on the perceived deformation of the genitalia after urethroplasty, which underscores the significance of urologists setting realistic expectations for patients with thorough pre-operative counseling.

A review of medical malpractice cases in congenital cardiac surgery in the Westlaw database in the United States from 1994 to 2019

Medical malpractice litigations are common for cardiac surgeons, and congenital cardiac surgeons are uniquely held accountable by patients, who are minors, and their families. Therefore, it is imperative for physicians to be cognizant of clinically effective and legally tenable practices. The Westlaw legal research service was utilized to collect medical malpractice litigations from 1994 to 2019 pertaining to congenital cardiac surgery, inclusive, in the United States. Court documents were manually screened, with 177 litigations satisfying criteria for inclusion. Data collection included patient demographics, verdict and litigation characteristics, and clinical data. Fisher's exact test was used to assess the significance of association. Across the 177 litigations, 44% had defendant verdicts, 30% had plaintiff verdicts, and 26% had settlements. The average plaintiff award was $9,363,710, and the average settlement was $4,141,825. Patient mortality occurred in 87 cases (49.2%), and wrongful death claims were argued in 71 cases (40%). The most common reason for litigation were procedural errors (79 cases, 45%). The most frequent clinical event was cardiac arrest (95 cases, 54%). California recorded the most litigations (34 cases, 19.2%). Defendant verdicts were significantly associated with cardiac arrest, procedural errors, and permanent neurological injury (p < .05). Defendant's verdicts were more common in cases with patient mortality, which had lower average plaintiff awards and settlements, since future healthcare expenses are inapplicable to this cohort. Future litigations can be minimized with an emphasis on reducing procedural errors, treating and diagnosing patients timely, and monitoring patients sufficiently.

Malpractice Litigation in Glaucoma

To analyze and report the causes and outcomes of malpractice litigation for patients with a diagnosis of glaucoma. Retrospective case series. Malpractice litigation cases. The WestLaw database was reviewed for all malpractice litigation with ophthalmologist defendants in the United States between 1930 and 2014. All litigation involving glaucoma was included in this analysis and was compared with litigation in ophthalmology as a whole. The primary outcomes were the number of cases, jury award amounts, whether the case resolved in favor of the defendant, and the type of glaucomatous disease or procedure with the highest amount of litigation. Sixty-nine glaucoma malpractice cases were included. Overall, 62.3% of cases were resolved in favor of defendants. Twenty-nine cases were resolved via jury trial, 8 of which were associated with plaintiff verdicts with a mean adjusted jury award of $994 260. Ten cases resulted in settlements with mean adjusted indemnity of $1 210 414. Commonly litigated allegations included mismanagement of glaucoma (20.3%), failure to diagnose glaucoma (17.4%), failure to diagnose or mismanagement of angle-closure glaucoma (18.5%), adverse drug effects (14.5%), and trabeculectomy complications (8.7%). Overall, the median plaintiff award for all of glaucoma litigation was $977 476; the median award across all ophthalmic subspecialties was $568 302 (P= 0.25). For jury verdicts alone, the median award in glaucoma was $977 474, compared with $604 352 for all ophthalmology (P= 0.05). For settlements alone, the median indemnity payment in glaucoma was $955 988, compared with $827 051 for all ophthalmology (P= 0.24). Overall, the rate of plaintiff verdicts was similar in glaucoma and in ophthalmology as a whole; however, the magnitude of plaintiff awards was higher in glaucoma than in ophthalmology overall. Common scenarios leading to litigation included failure to diagnose or mismanagement of glaucomatous disease, as well as adverse drug effects and surgical complications. Many cases could have been avoided with careful examinations, thorough documentation in the patients' charts, and detailed conversations with patients.

Malpractice Litigation in Vitreoretinal Surgery and Medical Retina.

To report and analyze the causes and outcomes of vitreoretinal surgery and medical retina malpractice litigation. The WestLaw database was reviewed for all vitreoretinal malpractice litigation in the United States between 1930 and 2014. One hundred forty-two retina cases were included. Overall, 64.1% of cases were resolved in favor of defendants. Eighty-three (58.5%) cases were resolved via jury trial, 30.1% of which were associated with plaintiff verdicts with mean adjusted jury award of $5,222,894 (median, $691,974). Eight cases (5.6%) resulted in settlements with mean adjusted indemnity of $726,003 (median: $437,165). Jury awards were higher than settlement awards (P = .04). Commonly litigated scenarios included retinal detachment (46.5%) and retinopathy of prematurity (9.2%). The complexity of treating vitreoretinal problems and the high potential for vision loss inherent in many diagnoses make treating retinal problems high-risk. Many cases in this series resulted in multi-million-dollar plaintiff awards. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:272-278.].

Medical Malpractice Litigation in Non-Mesh-Related Pelvic Organ Prolapse Surgery: An Analysis of 91 Cases.

Malpractice litigations have significant implications for patients and physicians. Studies have investigated mesh litigations in female pelvic reconstructive surgery, but none on nonmesh pelvic organ prolapse (POP) surgery. Our purpose is to determine the reasons for and outcomes of medical malpractice after nonmesh POP surgery. Westlaw (Thompson Reuters, New York, New York) is a legal research database of US court records. We identified completed POP litigations from 1987 to 2018 using the following: "pelvic organ prolapse," "enterocele," "rectocele," "cystocele," "uterine prolapse," and "vaginal wall prolapse." Mesh-related cases were excluded. Outcomes included reasons for litigation, verdict, injury, and payments. Statistical analysis was performed with nonparametric tests and χ2 independence test. Ninety-one litigations were included. The median plaintiff age was 53 years (range, 36-85 years). The leading allegation was negligence of surgery (n = 59; 65%). The jury sided with the defendant physician in 67% of cases (n = 61). There was no association between case verdict and patient age (P = 0.781), geographic region (P = 0.824), or allegation (P = 0.904). The primary complications were urinary tract injury (n = 24; 26%), need for additional surgery (n = 22; 24%), and new postoperative urinary symptoms (n = 22; 24%). The median payout was $280,000 (interquartile range, $137,250-$1,300,000), with no difference between plaintiff awards or settlements (P = 0.659). The leading allegation of malpractice litigations for nonmesh POP surgery is negligence of surgery, whereas the most common complication was urinary tract injury. A verdict in favor of the physician defendant was the most likely outcome. Plaintiff awards and settlements were not statistically different with no variation by region or time.

Litigation Patterns in Inguinal Hernia Surgery: A 25 Year Review

BackgroundInguinal herniorraphyis among the most common procedures performed by general surgeons, but risk factors for litigation related to this surgery are poorly defined. MethodsCases were retrieved by searching the Westlaw database from 1991 through 2016 using the search terms “inguinal hernia” OR “inguinal herniorrhaphy” OR “inguinal hernioplasty” and “medical malpractice.” Data were compiled on the demographics of the patient, operative case details, nature of injury, legal allegations, verdicts, and indemnities. ResultsForty-six cases met inclusion criteria and were selected for review. Verdicts for the defendant predominated (67%). The average plaintiff's monetary award for a plaintiff verdict or settlement was $1.21 million (median $500,000). The most frequent legal argument was improper performance (n = 35, 76%), followed by failure of informed consent (n = 14, 30%). The most common complications were nerve/chronic pain (n = 20, 45%) and testicular damage (n = 10, 23%). No association was discovered between case outcome and patient gender (P = 0.231) or age (P = 0.899). Case outcome was not different between open and laparoscopic repairs (P = 0.722). Patient mortality was not associated with case outcome (P = 0.311). There was no chronological trend in case outcome or award amount. Settlement award amounts were not significantly different than plaintiff awards (P = 0.390). ConclusionsSuccessful litigation after inguinal hernia surgery was relatively infrequent—only 21.7%—with an additional 10.9% resulting in settlement awards. Case outcome in litigation for hernia surgery was not predicted by patient demographics, type of procedure, or type of complication in this data set.

Malpractice in colorectal surgery: a review of 122 medicolegal cases

BackgroundMedical malpractice has become a rising concern for physicians, affecting the cost and delivery of health care. Colorectal procedures account for 24% of all general surgery cases, a high-risk specialty, with 15% of its physicians facing malpractice suit annually. MethodsThe Westlaw legal database was used to identify colorectal malpractice cases. ResultsIn all, 122 of 230 lawsuits were included in this study. A majority of 65.6% were physician verdicts, 19.7% plaintiff verdicts, and 14.8% reached a settlement. Plaintiff payments were found to be significantly higher than settlement awards. The most common cause of alleged malpractice was failure to recognize a complication in a timely manner (45.1%), followed by damage to surrounding tissues (36.1%). ConclusionsThe most common cause of alleged malpractice was failure to recognize a complication in a timely manner, followed by damage to surrounding tissue. Plaintiff awards were significantly higher than settlement payments. It is important to understand the mechanism of malpractice allegations to better prevent litigation and improve patient care.

Clinical practice guidelines for pressure ulcer prevention can prevent malpractice lawsuits in older patients

Objective: To evaluate the impact of implementation of and compliance with practice guidelines for pressure ulcer (PU) prevention using medical malpractice litigation data. Setting and Subjects: Forty-nine plaintiffs whose respective compensations ($14,418,770 in 35 plaintiffs) or dismissals had been reported in 2 legal databases. PU verdicts and settlements for plaintiffs 60 years of age and older were evaluated using the American Geriatric Society's Clinical Practice Guidelines, “Pressure Ulcers in Adults: Prediction and Prevention.” Methods: Litigation analysis was used to identify the effect, implementation of, and compliance with PU prevention practice guidelines on malpractice awards in PU lawsuits. Data were obtained using fact patterns from 2 legal databases, LEXIS and WESTLAW. Potential decreases in plaintiff awards and prevention of disability were calculated assuming that health care defendants had modified their behavior to conform to the practice guidelines. Possible increases in defendant awards were used to estimate the added risks to health care professionals of adopting these guidelines as the standard of care. Main Outcome Measures: Projected changes in verdicts, monetary awards expressed in dollars, and disability score. Results: Had health care defendants followed these guidelines, $11,389,989 might have been saved in 20 lawsuits. Violations of guidelines appeared to “cluster” together, with many plaintiffs alleging breeches of several interrelated guidelines. It appears that improving the level of care required to remedy 1 guideline variation could improve the outcomes for the entire cluster. In contrast, the use of the guidelines in court as the standard of care against defendant health care professionals might have contributed to changing only 4 of 14 defense verdicts. Conclusions: Use of clinical pathways in these settings can benefit both caregivers and patients by favorably modifying preventive practice patterns while decreasing vulnerability to litigation. Conversely, the continuing threat of fault-based litigation against substandard practitioners and facilities provides an ongoing safeguard of patient rights and reduces the risk of subsequent disability.

A review of transfusion-associated AIDS litigation: 1984 through 1993.

Since 1984, hundreds of lawsuits have been filed against health care providers in the United States, alleging transmission of human immunodeficiency virus by transfusion. While anecdotal reports of jury verdicts have been published, no quantitative study to identify trends in transfusion-associated AIDS litigation has been undertaken. To identify trends in lawsuits filed against health care providers alleging human immunodeficiency virus infection transmitted via transfusion, 163 legal actions were analyzed. Included were those for which the authors provided legal defense or consultation (n = 79) and cases reported nationally (n = 84). Cases were analyzed as to characteristics of defendant(s), date of transfusion and case filing, liability theories, and verdict, if applicable. Defendants were blood centers (74% of cases), hospitals (58%), and physicians (53%). Of physicians, surgeons were named in 78 percent of cases; 42 percent of these surgeons were cardiothoracic surgeons. Nationally, 14 cases have resulted in plaintiff awards totalling $75,420,798. Physicians have been liable for 41 percent of that sum, blood banks 31 percent, and hospitals 26 percent. Of the 10 liability theories raised, the most frequent were claims of medical negligence (46% of cases), failure to identify high-risk donors (45%), lack of informed consent (39%), and failure to conduct surrogate testing (39%). Twenty-six trial results favorable to health care providers were noted nationally, 17 occurring in the San Francisco Bay Area, where case filings peaked before 1990 (40/56) and where new case filings decreased (1990, 5; 1991, 3; 1992, 1; 1993, 0) as verdicts favoring health care providers were reported. Transfusion-associated AIDS litigation began with verdicts against blood banks, but has expanded to suits against physicians and hospitals that are based on theories of medical negligence and informed consent. Despite widely publicized verdicts for plaintiffs, health care professionals have successfully defended these lawsuits, and in one center of early litigation, a sharp decrease in new case filings has been observed.

Tort Reform and Manufacturer Payout - An Early Look at the California Experience

Manufacturers actively lobbied in the 1980s for legislative intervention in the tort system that would ease the burden on defendants in products liability cases. In response, all states enacted some type of general tort reform. California eliminated joint and several liability for noneconomic damages with the approval by voters in 1986 of Proposition 51. This paper evaluates the effectiveness of the California reform on manufacturer outcomes in products liability cases. The results suggest that manufacturers are paying a lower proportion of plaintiff awards than they would have in the absence of Proposition 51.

Using a patent database to boost R & D

Objective: To evaluate the impact of implementation of and compliance with practice guidelines for pressure ulcer (PU) prevention using medical malpractice litigation data.Setting and Subjects: Forty-nine plaintiffs whose respective compensations ($14,418,770 in 35 plaintiffs) or dismissals had been reported in 2 legal databases. PU verdicts and settlements for plaintiffs 60 years of age and older were evaluated using the American Geriatric Society's Clinical Practice Guidelines, “Pressure Ulcers in Adults: Prediction and Prevention.”Methods: Litigation analysis was used to identify the effect, implementation of, and compliance with PU prevention practice guidelines on malpractice awards in PU lawsuits. Data were obtained using fact patterns from 2 legal databases, LEXIS and WESTLAW. Potential decreases in plaintiff awards and prevention of disability were calculated assuming that health care defendants had modified their behavior to conform to the practice guidelines. Possible increases in defendant awards were used to estimate the added risks to health care professionals of adopting these guidelines as the standard of care.Main Outcome Measures: Projected changes in verdicts, monetary awards expressed in dollars, and disability score.Results: Had health care defendants followed these guidelines, $11,389,989 might have been saved in 20 lawsuits. Violations of guidelines appeared to “cluster” together, with many plaintiffs alleging breeches of several interrelated guidelines. It appears that improving the level of care required to remedy 1 guideline variation could improve the outcomes for the entire cluster. In contrast, the use of the guidelines in court as the standard of care against defendant health care professionals might have contributed to changing only 4 of 14 defense verdicts.Conclusions: Use of clinical pathways in these settings can benefit both caregivers and patients by favorably modifying preventive practice patterns while decreasing vulnerability to litigation. Conversely, the continuing threat of fault-based litigation against substandard practitioners and facilities provides an ongoing safeguard of patient rights and reduces the risk of subsequent disability.

Delivery of German patent information

Objective: To evaluate the impact of implementation of and compliance with practice guidelines for pressure ulcer (PU) prevention using medical malpractice litigation data.Setting and Subjects: Forty-nine plaintiffs whose respective compensations ($14,418,770 in 35 plaintiffs) or dismissals had been reported in 2 legal databases. PU verdicts and settlements for plaintiffs 60 years of age and older were evaluated using the American Geriatric Society's Clinical Practice Guidelines, “Pressure Ulcers in Adults: Prediction and Prevention.”Methods: Litigation analysis was used to identify the effect, implementation of, and compliance with PU prevention practice guidelines on malpractice awards in PU lawsuits. Data were obtained using fact patterns from 2 legal databases, LEXIS and WESTLAW. Potential decreases in plaintiff awards and prevention of disability were calculated assuming that health care defendants had modified their behavior to conform to the practice guidelines. Possible increases in defendant awards were used to estimate the added risks to health care professionals of adopting these guidelines as the standard of care.Main Outcome Measures: Projected changes in verdicts, monetary awards expressed in dollars, and disability score.Results: Had health care defendants followed these guidelines, $11,389,989 might have been saved in 20 lawsuits. Violations of guidelines appeared to “cluster” together, with many plaintiffs alleging breeches of several interrelated guidelines. It appears that improving the level of care required to remedy 1 guideline variation could improve the outcomes for the entire cluster. In contrast, the use of the guidelines in court as the standard of care against defendant health care professionals might have contributed to changing only 4 of 14 defense verdicts.Conclusions: Use of clinical pathways in these settings can benefit both caregivers and patients by favorably modifying preventive practice patterns while decreasing vulnerability to litigation. Conversely, the continuing threat of fault-based litigation against substandard practitioners and facilities provides an ongoing safeguard of patient rights and reduces the risk of subsequent disability.