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A Long, Unnerving Road: Malpractice Claims Involving the Surgical Management of Thyroid and Parathyroid Disease

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Abstract

Background

Given their profound emotional, physical, and financial toll on patients and surgeons, we studied the characteristics, costs, and contributing factors of thyroid and parathyroid surgical malpractice claims.

Methods

Using the Controlled Risk Insurance Company Strategies’ Comparative Benchmarking System database, representing ~30% of all US paid and unpaid malpractice claims, 5384 claims filed against general surgeons and otolaryngologists from 1995–2015 were reviewed to isolate claims involving the surgical management of thyroid and parathyroid disease. These claims were studied, and multivariable regression analysis was performed to identify factors associated with plaintiff payout.

Results

One hundred twenty-eight thyroid and parathyroid surgical malpractice claims were isolated. The median time from alleged harm event to closure of a malpractice case was 39 months. The most common associated complications were bilateral recurrent laryngeal nerve (RLN) injury (n = 23) and hematoma (n = 18). Complications led to death in 18 cases. Patient payout occurred in 33% of claims (n = 42), and the median cost per claim was $277,913 (IQR $87,343–$783,663). On multivariable analysis, bilateral RLN injury was predictive of patient payout (OR 3.58, p = 0.03), while procedure, death, and surgeon specialty were not.

Conclusion

Though rare, malpractice claims related to thyroid and parathyroid surgery are costly, time-consuming, and reveal opportunities for early surgeon–patient resolution after poor outcomes.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Rajshri M. Gartland, Jordan P. Bloom, Sareh Parangi, Richard Hodin, Antonia E. Stephen, Vinod Narra & Carrie C. Lubitz

  2. Lawrence Center for Quality and Safety, Massachusetts General Hospital, Massachusetts General Physicians Organization, Boston, MA, USA

    Rajshri M. Gartland & Elizabeth Mort

  3. CRICO Risk Management Foundation, Boston, MA, USA

    Courtney DeRoo

  4. Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Elizabeth Mort

Authors
  1. Rajshri M. Gartland
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  2. Jordan P. Bloom
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  3. Sareh Parangi
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  4. Richard Hodin
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  5. Courtney DeRoo
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  6. Antonia E. Stephen
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  7. Vinod Narra
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  8. Carrie C. Lubitz
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  9. Elizabeth Mort
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Correspondence to Rajshri M. Gartland.

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Gartland, R.M., Bloom, J.P., Parangi, S. et al. A Long, Unnerving Road: Malpractice Claims Involving the Surgical Management of Thyroid and Parathyroid Disease. World J Surg 43, 2850–2855 (2019). https://doi.org/10.1007/s00268-019-05102-y

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  • DOI: https://doi.org/10.1007/s00268-019-05102-y

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