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Malodorous consequences: What comprises negligence in anosmia litigation?

Authors

  • Peter F. Svider MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI
    • Correspondence to: Peter F. Svider, MD, Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, 4201 St. Antoine, 5E-UHC, Detroit, MI 48201; e-mail: psvider@gmail.com

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  • Andrew C. Mauro BA,

    1. The University of Michigan Law School, Ann Arbor, MI
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  • Jean Anderson Eloy MD, FACS,

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

    1. Rhinology Section, North Shore University Hospital, Manhasset, NY
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  • Michael A. Carron MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI
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  • Adam J. Folbe MD

    1. Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI
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  • Potential conflict of interest: M.S. is a speaker for TEVA and MEDA on their Speakers Bureau.

Abstract

Background

Our objectives were to evaluate factors raised in malpractice litigation in which plaintiffs alleged that physician negligence led to olfactory dysfunction.

Methods

We analyzed publically available federal and court records using Westlaw, a widely used computerized legal database. Pertinent jury verdicts and settlements were comprehensively examined for alleged causes of malpractice (including procedures for iatrogenic causes), defendant specialty, patient demographics, and other factors raised in legal proceedings.

Results

Of 25 malpractice proceedings meeting inclusion criteria, 60.0% were resolved for the defendant, 12.0% were settled, and 28.0% had jury-awarded damages. Median payments were significant ($300,000 and $412,500 for settlements and awards, respectively). Otolaryngologists were the most frequently named defendants (68.0%), with the majority of iatrogenic cases (55.0%) related to rhinologic procedures. Associated medical events accompanying anosmia included dysgeusia, cerebrospinal fluid leaks, and meningitis. Other alleged factors included requiring additional surgery (80.0%), unnecessary procedures (47.4% of iatrogenic procedural cases), untimely diagnosis leading to anosmia (44.0%), inadequate informed consent (35.0%), dysgeusia (56.0%), and psychological sequelae (24.0%).

Conclusion

Olfactory dysfunction can adversely affect quality of life and thus is a potential area for malpractice litigation. This is particularly true for iatrogenic causes of anosmia, especially following rhinologic procedures. Settlements and damages awarded were considerable, making an understanding of factors detailed in this analysis of paramount importance for the practicing otolaryngologist. This analysis reinforces the importance of explicitly including anosmia in a comprehensive informed consent process for any rhinologic procedure.

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