Medical malpractice lawsuits involving surgical residents

Cornelius A. Thiels, Asad J. Choudhry, Mohamed Ray-Zack, Rachel A. Lindor, John R. Bergquist, Elizabeth B. Habermann, Martin D. Zielinski

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

IMPORTANCE Medical malpractice litigation against surgical residents is rarely discussed owing to assumed legal doctrine of respondeat superior, or "let the master answer." OBJECTIVE To better understand lawsuits targeting surgical trainees to prevent future litigation. DESIGN, SETTING, AND PARTICIPANTS Westlaw, an online legal research database containing legal records from across the United States, was retrospectively reviewed for malpractice cases involving surgical interns, residents, or fellows from January 1, 2005, to January 1, 2015. Infant-related obstetric and ophthalmologic procedures were excluded. EXPOSURES Involvement in a medical malpractice case. MAIN OUTCOMES AND MEASURES Datawere collected on patient demographics, case characteristics, and outcomes and were analyzed using descriptive statistics. RESULTS During a 10-year period, 87 malpractice cases involving surgical trainees were identified. A total of 50 patients were female (57%), and 79 were 18 years of age or older (91%), with a median patient age of 44.5 years (interquartile range, 45-56 years). A total of 67 cases (77%) resulted in death or permanent disability. Most cases involved elective surgery (61 [70%]) and named a junior resident as a defendant (24 of 35 [69%]). Cases more often questioned the perioperative medical knowledge, decision making errors, and injuries (53 [61%]: preoperative, 19 of 53 [36%]) and postoperative, 34 of 53 [64%]) than intraoperative errors and injuries (43 [49%]). Junior residents were involved primarily with lawsuits related to medical decision making (21 of 24 [87%]). Residents' failure to evaluate the patient was cited in 10 cases (12%) and lack of direct supervision by attending physicians was cited in 48 cases (55%). A total of 42 cases (48%) resulted in a jury verdict or settlement in favor of the plaintiff, with a median payout of $900 000 (range, $1852 to $32 million). CONCLUSIONS AND RELEVANCE This review of malpractice cases involving surgical residents highlights the importance of perioperative management, particularly among junior residents, and the importance of appropriate supervision by attending physicians as targets for education on litigation prevention.

Original languageEnglish (US)
Pages (from-to)8-13
Number of pages6
JournalJAMA Surgery
Volume153
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

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Malpractice
Jurisprudence
Physicians
Wounds and Injuries
Obstetrics
Demography
Databases
Education
Research
Clinical Decision-Making

ASJC Scopus subject areas

  • Surgery

Cite this

Thiels, C. A., Choudhry, A. J., Ray-Zack, M., Lindor, R. A., Bergquist, J. R., Habermann, E. B., & Zielinski, M. D. (2018). Medical malpractice lawsuits involving surgical residents. JAMA Surgery, 153(1), 8-13. https://doi.org/10.1001/jamasurg.2017.2979

Medical malpractice lawsuits involving surgical residents. / Thiels, Cornelius A.; Choudhry, Asad J.; Ray-Zack, Mohamed; Lindor, Rachel A.; Bergquist, John R.; Habermann, Elizabeth B.; Zielinski, Martin D.

In: JAMA Surgery, Vol. 153, No. 1, 01.01.2018, p. 8-13.

Research output: Contribution to journalArticle

Thiels, CA, Choudhry, AJ, Ray-Zack, M, Lindor, RA, Bergquist, JR, Habermann, EB & Zielinski, MD 2018, 'Medical malpractice lawsuits involving surgical residents', JAMA Surgery, vol. 153, no. 1, pp. 8-13. https://doi.org/10.1001/jamasurg.2017.2979
Thiels CA, Choudhry AJ, Ray-Zack M, Lindor RA, Bergquist JR, Habermann EB et al. Medical malpractice lawsuits involving surgical residents. JAMA Surgery. 2018 Jan 1;153(1):8-13. https://doi.org/10.1001/jamasurg.2017.2979
Thiels, Cornelius A. ; Choudhry, Asad J. ; Ray-Zack, Mohamed ; Lindor, Rachel A. ; Bergquist, John R. ; Habermann, Elizabeth B. ; Zielinski, Martin D. / Medical malpractice lawsuits involving surgical residents. In: JAMA Surgery. 2018 ; Vol. 153, No. 1. pp. 8-13.
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abstract = "IMPORTANCE Medical malpractice litigation against surgical residents is rarely discussed owing to assumed legal doctrine of respondeat superior, or {"}let the master answer.{"} OBJECTIVE To better understand lawsuits targeting surgical trainees to prevent future litigation. DESIGN, SETTING, AND PARTICIPANTS Westlaw, an online legal research database containing legal records from across the United States, was retrospectively reviewed for malpractice cases involving surgical interns, residents, or fellows from January 1, 2005, to January 1, 2015. Infant-related obstetric and ophthalmologic procedures were excluded. EXPOSURES Involvement in a medical malpractice case. MAIN OUTCOMES AND MEASURES Datawere collected on patient demographics, case characteristics, and outcomes and were analyzed using descriptive statistics. RESULTS During a 10-year period, 87 malpractice cases involving surgical trainees were identified. A total of 50 patients were female (57{\%}), and 79 were 18 years of age or older (91{\%}), with a median patient age of 44.5 years (interquartile range, 45-56 years). A total of 67 cases (77{\%}) resulted in death or permanent disability. Most cases involved elective surgery (61 [70{\%}]) and named a junior resident as a defendant (24 of 35 [69{\%}]). Cases more often questioned the perioperative medical knowledge, decision making errors, and injuries (53 [61{\%}]: preoperative, 19 of 53 [36{\%}]) and postoperative, 34 of 53 [64{\%}]) than intraoperative errors and injuries (43 [49{\%}]). Junior residents were involved primarily with lawsuits related to medical decision making (21 of 24 [87{\%}]). Residents' failure to evaluate the patient was cited in 10 cases (12{\%}) and lack of direct supervision by attending physicians was cited in 48 cases (55{\%}). A total of 42 cases (48{\%}) resulted in a jury verdict or settlement in favor of the plaintiff, with a median payout of $900 000 (range, $1852 to $32 million). CONCLUSIONS AND RELEVANCE This review of malpractice cases involving surgical residents highlights the importance of perioperative management, particularly among junior residents, and the importance of appropriate supervision by attending physicians as targets for education on litigation prevention.",
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