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Analysis of medical malpractice claims involving pediatric surgical conditions

Ruchi Amin, Camaleigh Jaber, Steven L Lee, Veronica F Sullins

Objective: Pediatric surgery is a high-risk specialty. We examine allegations and outcomes in malpractice claims involving index pediatric surgical conditions. Method: A retrospective review of malpractice claims concerning 11 index pediatric surgery diagnoses from 1984 to 2013 was performed using a publicly available database of state and federal court records. Results: Of the 411 cases reviewed, 284 (69%) documented a cause for alleged malpractice and 183 (45%) had outcome data of which 44% went to trial, 53% reached a settlement, and 13% were dismissed. Jury verdicts were in favor of the defendant in 69% of cases. Wrongful death was alleged in 46% of cases with the highest percentage in cases of abdominal wall defects (54%), CDH (53%) and malrotation/volvulus (52%). The most common cause for alleged malpractice was a delay or failure in diagnosis (53%), followed by negligence in postoperative care (20%) and negligence in surgery (8%). Forty-seven percent of all deaths were the result of an alleged failure or delay in diagnosis. Overall, the median jury trial award was $1,648,000 (IQR $655,000-6,125,000) and the median settlement was $1,103,668 (IQR $475,000-3,250,000). The most commonly named defendants were hospitals/medical groups (62%), followed by pediatricians (30%) and surgeons (26%). Conclusion: Delays or failures in diagnosis are the most common allegation in cases of malpractice in index pediatric surgery diagnoses and account for nearly half of all cases of wrongful death. Limiting patient complications and reducing medico-legal risk in pediatric surgery may be achieved by focusing on timely and accurate diagnosis across all pediatric specialties.