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Verdicts on malpractice claims after thyroid surgery: Emerging trends and future directions

Authors

  • Henning Dralle MD,

    Corresponding author
    1. Department of General, Visceral and Vascular Surgery, University Hospital and Medical Faculty, University of Halle–Wittenberg, Halle/Saale, Germany
    • Department of Surgery, University Hospital and Medical Faculty, University of Halle–Wittenberg, Halle/Saale, Germany
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  • Kerstin Lorenz MD,

    1. Department of General, Visceral and Vascular Surgery, University Hospital and Medical Faculty, University of Halle–Wittenberg, Halle/Saale, Germany
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  • Andreas Machens MD

    1. Department of General, Visceral and Vascular Surgery, University Hospital and Medical Faculty, University of Halle–Wittenberg, Halle/Saale, Germany
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Abstract

Background

Few investigations have addressed malpractice litigation after thyroid surgery. The purpose of this medico-legal review was to provide a more comprehensive picture of medico-legal trends in thyroid surgery.

Methods

Reviewed were all expert opinions on claims of malpractice after thyroid surgery, commissioned between 1995 and 2010 at 1 tertiary center, and their corresponding verdicts.

Results

Forty-three of 75 malpractice claims involved recurrent laryngeal nerve (RLN) palsy (21 unilateral and 22 bilateral palsies), with a 45% tracheostomy rate for bilateral RLN palsy. Twenty-one claims concerned permanent hypoparathyroidism. Since 2007, intraoperative nerve monitoring (IONM) has become the subject of pleading in 4 of 7 malpractice claims involving unilateral or bilateral RLN palsy. In none of these cases did IONM follow international standards, resulting in 3 plaintiff verdicts.

Conclusion

The growing appreciation that standardized IONM can prevent bilateral RLN palsies after signal loss on the initial side of resection may become increasingly relevant to malpractice litigation. © 2012 Wiley Periodicals, Inc. Head Neck, 2012

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