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Epistaxis: the factors involved in determining medicolegal liability

Authors

  • Mohemmed N. Khan MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
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  • Danielle M. Blake BA,

    1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
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  • Alejandro Vazquez MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
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  • Michael Setzen MD, FACS,

    1. Rhinology Section, North Shore University Hospital, Manhasset, NY
    2. Department of Otolaryngology, New York University School of Medicine, New York, NY
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  • Soly Baredes MD, FACS,

    1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
    2. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
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  • Jean Anderson Eloy MD, FACS

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
    2. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ
    3. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ
    • Correspondence to: Jean Anderson Eloy, MD, FACS, Rhinology, Sinus Surgery, and Endoscopic Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, 90 Bergen St., Suite 8100, Newark, NJ 07103; e-mail: Jean.anderson.eloy@gmail.com

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  • Potential conflict of interest: M.S. is a speaker for TEVA and MEDA on their Speakers Bureau.

  • Presented at the 59th Annual Meeting of the ARS, September 28, 2013, Vancouver, BC, Canada.

Abstract

Background

The purpose of this study was to examine litigation involving epistaxis and analyze factors that determine liability.

Methods

Jury verdicts and settlements regarding cases involving epistaxis were gathered utilizing the Westlaw database. Factors involved in litigation gathered included demographics, defendant specialty, procedure, alleged cause of malpractice, outcome, monetary award, and other variables.

Results

A total of 26 cases were analyzed. The majority of cases (57.7%) were decided in favor of the plaintiff or settled out of court. Total awards amounted to $24,501,252. Average awards for cases decided in favor of the plaintiff were $2,260,893 and ranged from $499,845 to $9,022,643. Settlements averaged $1,084,375 and ranged from $300,000 to $3,800,000. Common causes of malpractice encountered included delay in diagnosis, complications from medical procedures, and failure to recognize complications in a timely manner.

Conclusion

Contrary to previous reports analyzing malpractice for varying medical procedures and complications, litigation in epistaxis is more commonly resolved in favor of the plaintiff or resolved through out-of-court settlements. Substantial financial awards and therapeutic complications from blindness to death make epistaxis a candidate for litigation. Of importance from a medicolegal stand is the fact that 30.8% (8) of the patients involved in epistaxis litigation died, either from complications of therapy or from experiencing epistaxis as a complication of another procedure/pathology. Using necessary diagnostic imaging, ensuring proper management techniques, and recognizing complications in a timely manner can serve to limit legal liability and enhance patient safety.

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