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Esophageal Perforation and Rupture: a Comprehensive Medicolegal Examination of 59 Jury Verdicts and Settlements

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Consequences accompanying esophageal perforation make this complication a prime litigation target. We characterize factors in jury verdicts and settlements regarding esophageal perforation, including operative procedure, patient demographics, alleged cause(s) of malpractice, outcome, and other factors.

Methods

Pertinent court records were examined for the aforementioned factors.

Results

Gastroenterologists, general surgeons, and anesthesiologists were the most commonly named defendants. Two thirds of outcomes were for the defendant, and 11.9 % were settled (median—$650,000); 20.3 % resulted in awarded damages (median—$1.2 M). Esophagogastroduodenoscopy was the most commonly litigated procedure, followed by intubation and Nissen fundoplication. Necessity of repair, delayed diagnosis, death, and inadequate consent were the most frequently cited factors in litigation.

Conclusions

An understanding of the factors important in determining legal responsibility is of great interest for practitioners in multiple specialties. The requirement of surgical repair and a delay in diagnosis are two of the most common factors present in litigated cases resulting in a payment. The importance of explicitly listing esophageal perforation in the informed consent for esophagogastroduodenoscopy, abdominal surgery, and any patients at risk of intubation injury needs to be emphasized.

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Conflict of Interest

All the authors have no conflicts of interest.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA

    Peter F. Svider & Ravi J. Chokshi

  2. University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Peter F. Svider & Anna A. Pashkova

  3. Department of Surgery, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA

    Gian-Paul Vidal

  4. The University of Michigan Law School, Ann Arbor, MI, USA

    Andrew C. Mauro

  5. Department of Otolaryngology—Head and Neck Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA

    Jean Anderson Eloy

  6. Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA

    Jean Anderson Eloy

  7. Center for Skull Base and Pituitary Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA

    Jean Anderson Eloy

  8. New Jersey Medical School, UMDNJ, 90 Bergen St., Suite 8100, Newark, NJ, 07103, USA

    Peter F. Svider

Authors
  1. Peter F. Svider
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  2. Anna A. Pashkova
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  3. Gian-Paul Vidal
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  4. Andrew C. Mauro
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  5. Jean Anderson Eloy
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Corresponding author

Correspondence to Peter F. Svider.

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Svider, P.F., Pashkova, A.A., Vidal, GP. et al. Esophageal Perforation and Rupture: a Comprehensive Medicolegal Examination of 59 Jury Verdicts and Settlements. J Gastrointest Surg 17, 1732–1738 (2013). https://doi.org/10.1007/s11605-013-2261-y

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  • DOI: https://doi.org/10.1007/s11605-013-2261-y

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