Potential conflict of interest: None provided.
Physician accountability in iatrogenic cerebrospinal fluid leak litigation
Article first published online: 27 MAR 2013
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 9, pages 722–725, September 2013
How to Cite
How to Cite this Article: Physician accountability in iatrogenic cerebrospinal fluid leak litigation. Int Forum Allergy Rhinol. 2013;3:722–725., , , et al.
- Issue published online: 17 SEP 2013
- Article first published online: 27 MAR 2013
- Manuscript Accepted: 19 FEB 2013
- Manuscript Revised: 31 JAN 2013
- Manuscript Received: 20 DEC 2012
- iatrogenic cerebrospinal fluid leak;
- malpractice trial;
- rhinologic procedures
The potentially severe complications resulting from cerebrospinal fluid (CSF) leak makes iatrogenic injury a medicolegal area of concern for otolaryngologists and neurosurgeons. The objectives of this analysis were to study legal outcomes as well as medical and nonmedical elements affecting malpractice litigation.
Public court records available in the Westlaw legal database (Thomson Reuters, New York, NY) were searched for medical malpractice litigation related to iatrogenic CSF leak. Of the 18 jury verdicts and settlements included, outcomes and awards, patient demographic data, and other factors instrumental in determining legal responsibility were recorded for comparison.
Ten (55.6%) cases were resolved in the defendant's favor, 2 (11.1%) resulted in damages awarded by a jury, and 6 (33.3%) were settled out of court before resolution of trial. Mean damages awarded were $1.1 million, while out of court settlements averaged $966,887. Malpractice stemming from patients who underwent endoscopic sinus surgery comprised 77.8% of cases analyzed. The most frequent alleged factors cited for litigation included having to undergo additional surgery (88.9%), developing meningitis (50.0%), and failing to recognize complications in a timely manner (44.4%). Perceived deficits in informed consent were alleged in one-third of cases.
Although a slight majority of cases were resolved in the defendant's favor, payments made were considerable, averaging approximately $1 million. Strategies to decrease liability and allow patients to make more informed decisions should include clear communication with patients that explicitly states potential risks, such as meningitis, and possible need to undergo additional reparative surgery.