An analysis of malpractice litigation related to the management of brain aneurysms

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OBJECTIVE

Given the highly complex and demanding clinical environment in which neurosurgeons operate, the probability of facing a medical malpractice claim is high. Recent emphasis on tort reform within the political sphere has brought this issue to the forefront of medical literature. Despite the widespread fear of litigation in the medical community, few studies have provided an analysis of malpractice litigation in the field. Here, the authors attempt to delineate the medicolegal factors that impel plaintiffs to file medical malpractice claims related to the management of brain aneurysms, and to better characterize the nature of these lawsuits.

METHODS

The online legal database WestLawNext was searched to find all medical malpractice cases related to brain aneurysms across a 30-year period. All state and federal jury verdicts and settlements relevant to the search criterion were considered.

RESULTS

Sixty-six cases were obtained. The average age of the patient was 46.7 years. Seventy-one percent were female. The cases were distributed across 16 states. The jury found in favor of the plaintiff in 40.9% of cases, with a mean payout of $8,765,405, and in favor of the defendant in 28.8% of the cases. A failure to diagnose and/or a failure to treat in a timely manner were the 2 most commonly alleged causes of malpractice. Settlements, which were reached in 25.8% of the cases, had a mean payout of $1,818,250. Neurosurgeons accounted for 6.7% of all defendants.

CONCLUSIONS

Unlike other medical specialties, a majority of the verdicts were not in the defendant's favor. The mean payouts were nearly 5-fold less in cases in which a settlement was reached, as opposed to a summary judgment. Neurosurgeons accounted for a small percentage of all codefendants.

Article Information

Correspondence Raghav Gupta, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St., Ste. 3B, Boston, MA 02215. email: rgupta5@bidmc.harvard.edu.

INCLUDE WHEN CITING Published online December 23, 2016; DOI: 10.3171/2016.9.JNS161124.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Flow chart illustrating the search strategy.

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    Map illustrating the geographic distribution of the number of malpractice cases related to brain aneurysms in the US from 1985 to 2015. No cases were observed in either Hawaii or Alaska. Superimposed on these data are the states (these include Alaska and Hawaii, which are not shown) that have passed tort reform laws that limit the value of payouts related to noneconomic damages.

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    Pie charts showing a summary of the jury verdicts (A), and a breakdown of the specialties of the codefendants implicated in these cases, with further delineation of the subspecialties of the physicians involved (B). Figure is available in color online only.

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    Graph illustrating the number of malpractice cases relevant to the search criterion, over 5-year intervals, across a 30-year time span.

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