Thoracic Surgery Litigation: Analysis Using the Westlaw Legal Database

Abstract

Background: In the United States, medical malpractice bears a significant financial risk associated with surgery, particularly in the field of cardiothoracic surgery. Approximately 18.9% of cardiothoracic surgeons face litigation. We report an analysis of litigation in thoracic surgery.

Methods: The Westlaw legal database was used to identify thoracic surgery cases. Search terms were identified for various thoracic procedures. Case characteristics were analyzed.

Results: Medical malpractice in thoracic surgery results in a median payout of $1,183,000 million for plaintiff verdicts and a mean settlement award of $550,000. Outcomes of litigation are variable. Geographic location does not play a significant role in litigation. Thoracic surgeons in New York, California, Florida, and Illinois faced the most lawsuits. Intraoperative or procedural error and inadequate informed consent accounted for 52% of all cases.

Conclusions: Attempts to increase patient understanding and education may be beneficial for reducing litigation. Analysis of why New York, California, and Illinois are highly litigious is warranted. Future analysis would also be useful to evaluate whether advances in techniques, such as robotic or thoracoscopic approaches, are associated with reduced incidence of litigation.

Figure 1

Geographic distribution of thoracic surgery lawsuits. Illinois, California, New York, and Florida faced the highest incidence of litigation with 19, 17, 16, and 16 cases, respectively. Alabama had the highest rate of litigation at 0.48 case per practicing physician.

Figure 2

Regional litigation outcomes. The Northeast (NE) included Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New Jersey, New York, and Pennsylvania. The Midwest (MW) included Illinois, Indiana, Michigan, Ohio, Wisconsin, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota. The South included Delaware, Florida, Georgia, Maryland, North Carolina, South, Carolina, Virginia, Washington, DC, West Virginia, Alabama, Kentucky, Mississippi, Tennessee, Arkansas, Louisiana, Oklahoma, and Texas. The West included Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming, Alaska, California, Hawaii, Oregon, and Washington. The Northeast faced the highest median settlement awards at $4,150,000, whereas the South had the highest median amount paid for plaintiff at $1,297,000.