TY - JOUR
T1 - Neurologic Injury Predicts Plaintiff Award in Federal Cardiac Surgery Trials
AU - Hui, Dawn S.
AU - Miles, Katie M.
AU - Lee, Richard
N1 - Funding Information:
Whereas outcomes research in cardiothoracic surgery is supported by well-designed centralized databases with broad national inclusion and validated analytic techniques, the current state of data sources in medicolegal scholarship is quite different. Data sources consist primarily of legal narratives and opinions, with no existing codification structure. The data extracted for this study required a review of purely free text documents that were variable in quality and precision. This necessitated review by a cardiac surgeon and a legal specialist for case and document eligibility, interpretation of imprecise medical terms, and codification. The resources required to review the large volume of state court cases or all malpractice claims would likely be prohibitive without advances in techniques.
Publisher Copyright:
© 2018 The Society of Thoracic Surgeons
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - Background: Cardiothoracic surgery is one of the more highly litigated medical specialties. The incidence and outcomes of federal cases related to cardiac surgery have not been previously explored. Methods: A legal research service was queried for cardiac surgery-related terms. Citations and related documents were reviewed for relevance and case details. Inclusion criteria were federal district court cases involving cardiac operations. Exclusion criteria were rulings on solely procedural matters. Associations were explored using the Fisher exact test. Results: Of 354 unique citations from 1956 to 2017, 19.2% (n = 68) met criteria. The highest number of cases (25% [n = 17]) were litigated in the Third Circuit. Operations involved coronary artery bypass grafting in 33.8% (n = 23), valves in 32.4% (n = 22), and congenital operations in 19.1% (n = 13). Litigation was prompted by media reporting in 10.3% (n = 7) and involved neurologic injury in 17.6% (n = 12), death in 33.8% (n = 23), and informed consent issues in 29.4% (n = 20). Findings were summary judgment for the defendant in 45.6% (n = 31), partial summary judgment in 17.6% (n = 12), dismissal in 27.9% (n = 19), and ruling for the plaintiff in 7.4% (n = 5). Of the rulings for the plaintiffs, damages had a median dollar amount of $591,300 (interquartile range, $214,2673.50 to $5,807,687.00]. In Fisher's exact test analysis, neurologic injury was significantly associated with ruling for the plaintiff (p < 0.01); death, surgeon defendant, surgical decision-making/conduct, and adult cardiac case type were not associated. Conclusions: Federal cardiac malpractice court cases are rare. Rulings in favor of the plaintiff, although also rare, are associated with neurologic injury. A comprehensive picture of cardiac surgery-related litigation will require advances in data abstraction techniques and codification.
AB - Background: Cardiothoracic surgery is one of the more highly litigated medical specialties. The incidence and outcomes of federal cases related to cardiac surgery have not been previously explored. Methods: A legal research service was queried for cardiac surgery-related terms. Citations and related documents were reviewed for relevance and case details. Inclusion criteria were federal district court cases involving cardiac operations. Exclusion criteria were rulings on solely procedural matters. Associations were explored using the Fisher exact test. Results: Of 354 unique citations from 1956 to 2017, 19.2% (n = 68) met criteria. The highest number of cases (25% [n = 17]) were litigated in the Third Circuit. Operations involved coronary artery bypass grafting in 33.8% (n = 23), valves in 32.4% (n = 22), and congenital operations in 19.1% (n = 13). Litigation was prompted by media reporting in 10.3% (n = 7) and involved neurologic injury in 17.6% (n = 12), death in 33.8% (n = 23), and informed consent issues in 29.4% (n = 20). Findings were summary judgment for the defendant in 45.6% (n = 31), partial summary judgment in 17.6% (n = 12), dismissal in 27.9% (n = 19), and ruling for the plaintiff in 7.4% (n = 5). Of the rulings for the plaintiffs, damages had a median dollar amount of $591,300 (interquartile range, $214,2673.50 to $5,807,687.00]. In Fisher's exact test analysis, neurologic injury was significantly associated with ruling for the plaintiff (p < 0.01); death, surgeon defendant, surgical decision-making/conduct, and adult cardiac case type were not associated. Conclusions: Federal cardiac malpractice court cases are rare. Rulings in favor of the plaintiff, although also rare, are associated with neurologic injury. A comprehensive picture of cardiac surgery-related litigation will require advances in data abstraction techniques and codification.
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U2 - 10.1016/j.athoracsur.2018.03.061
DO - 10.1016/j.athoracsur.2018.03.061
M3 - Article
C2 - 29723534
AN - SCOPUS:85051648921
VL - 106
SP - 691
EP - 695
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 3
ER -