Investigation of litigation in trauma orthopaedic surgery

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

BACKGROUND

It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.

AIM

To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.

METHODS

A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.

RESULTS

A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively. Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.

CONCLUSION

Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.

Related collections

Most cited references 28

Record: found
Abstract: found
Article: found

Is Open Access

Hospital volume and mortality for 25 types of inpatient treatment in German hospitals: observational study using complete national data from 2009 to 2014

Ulrike Nimptsch, Thomas Mansky (2017)

Objectives To explore the existence and strength of a relationship between hospital volume and mortality, to estimate minimum volume thresholds and to assess the potential benefit of centralisation of services. Design Observational population-based study using complete German hospital discharge data (Diagnosis-Related Group Statistics (DRG Statistics)). Setting All acute care hospitals in Germany. Participants All adult patients hospitalised for 1 out of 25 common or medically important types of inpatient treatment from 2009 to 2014. Main outcome measure Risk-adjusted inhospital mortality. Results Lower inhospital mortality in association with higher hospital volume was observed in 20 out of the 25 studied types of treatment when volume was categorised in quintiles and persisted in 17 types of treatment when volume was analysed as a continuous variable. Such a relationship was found in some of the studied emergency conditions and low-risk procedures. It was more consistently present regarding complex surgical procedures. For example, about 22 000 patients receiving open repair of abdominal aortic aneurysm were analysed. In very high-volume hospitals, risk-adjusted mortality was 4.7% (95% CI 4.1 to 5.4) compared with 7.8% (7.1 to 8.7) in very low volume hospitals. The minimum volume above which risk of death would fall below the average mortality was estimated as 18 cases per year. If all hospitals providing this service would perform at least 18 cases per year, one death among 104 (76 to 166) patients could potentially be prevented. Conclusions Based on complete national hospital discharge data, the results confirmed volume–outcome relationships for many complex surgical procedures, as well as for some emergency conditions and low-risk procedures. Following these findings, the study identified areas where centralisation would provide a benefit for patients undergoing the specific type of treatment in German hospitals and quantified the possible impact of centralisation efforts.

0 comments Cited 48 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Risk management: extreme honesty may be the best policy.

Steve Kraman, Ginny Hamm (1999)

This paper reviews a humanistic risk management policy that includes early injury review, steadfast maintenance of the relationship between the hospital and the patient, proactive full disclosure to patients who have been injured because of accidents or medical negligence, and fair compensation for injuries. The financial consequences of this type of policy are not yet known; however, one Veterans Affairs medical center, which has been using humanistic risk management since 1987, has had encouragingly moderate liability payments. The Department of Veterans Affairs now requires such a policy for all of its facilities; therefore, comprehensive experience may be only a few years away.

0 comments Cited 40 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

Sayon Dutta, William J. Long, David Brown … (2013)

As use of radiology studies increases, there is a concurrent increase in incidental findings (eg, lung nodules) for which the radiologist issues recommendations for additional imaging for follow-up. Busy emergency physicians may be challenged to carefully communicate recommendations for additional imaging not relevant to the patient's primary evaluation. The emergence of electronic health records and natural language processing algorithms may help address this quality gap. We seek to describe recommendations for additional imaging from our institution and develop and validate an automated natural language processing algorithm to reliably identify recommendations for additional imaging. We developed a natural language processing algorithm to detect recommendations for additional imaging, using 3 iterative cycles of training and validation. The third cycle used 3,235 radiology reports (1,600 for algorithm training and 1,635 for validation) of discharged emergency department (ED) patients from which we determined the incidence of discharge-relevant recommendations for additional imaging and the frequency of appropriate discharge documentation. The test characteristics of the 3 natural language processing algorithm iterations were compared, using blinded chart review as the criterion standard. Discharge-relevant recommendations for additional imaging were found in 4.5% (95% confidence interval [CI] 3.5% to 5.5%) of ED radiology reports, but 51% (95% CI 43% to 59%) of discharge instructions failed to note those findings. The final natural language processing algorithm had 89% (95% CI 82% to 94%) sensitivity and 98% (95% CI 97% to 98%) specificity for detecting recommendations for additional imaging. For discharge-relevant recommendations for additional imaging, sensitivity improved to 97% (95% CI 89% to 100%). Recommendations for additional imaging are common, and failure to document relevant recommendations for additional imaging in ED discharge instructions occurs frequently. The natural language processing algorithm's performance improved with each iteration and offers a promising error-prevention tool. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

0 comments Cited 27 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Maryam Salimi

Mohammad Bagher Heidari

Zohre Ravandi

Seyedarad Mosalamiaghili

Peyman Mirghaderi

Meisam Jafari Kafiabadi

Farsad Biglari

Amirhossein Salimi

Amir Sabaghzadeh Irani

Seyyed Saeed Khabiri

Journal

Journal ID (nlm-ta): World J Clin Cases

Journal ID (publisher-id): WJCC

Title: World Journal of Clinical Cases

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 2307-8960

Publication date (Print): 16 February 2023

Publication date (Electronic): 16 February 2023

Volume: 11

Issue: 5

Pages: 1000-1008

Affiliations

Department of Orthopaedic Surgery, Shiraz University of Medical Sciences, Shiraz 7138433608, Iran

Department of General Surgery, Kermanshah University of Medical Sciences, Kermanshah 71384333608, Iran

Student Research Committee, Kermanshah University of Medical Sciences, Shiraz 7138438756, Iran

Student Research Committee, Shiraz University of Medical Sciences, Shiraz 716549834, Iran

Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran 714356743, Iran

Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 715643498, Iran

Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd 719167534, Iran

Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 715643498, Iran

Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 715643498, Iran. saeed.khabiri@ 123456gmail.com

Author notes

Author contributions: Khabiri SS designed and performed the research; Heidari MB and Ravandi Z designed the research and collected the data; Mosalamiaghili S and Jafari Kafiabadi M designed the research and contributed to the analysis and interpreted the result; Mirghaderi P, Biglari F, and Sabaghzadeh Irani A designed the research and drafted the manuscript; Salimi M designed the research and wrote the paper; Salimi M designed the research and edited significantly.

Corresponding author: Seyyed Saeed Khabiri, MD, Assistant Professor, Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Velenjak 7th Floor, Bldg No. 2 SBUMS, Arabi Ave, Tehran 715643498, Iran. saeed.khabiri@ 123456gmail.com

Article

Other ID: jWJCC.v11.i5.pg1000

DOI: 10.12998/wjcc.v11.i5.1000

PMC ID: 9979292

PubMed ID: 36874422

SO-VID: c2b55f9e-015e-47c3-a6da-f37e26c117d8

License:

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

History

Date received : 9 October 2022

Date revision received : 23 December 2022

Date accepted : 16 January 2023

Comments

Comment on this article

scite_

Investigation of litigation in trauma orthopaedic surgery

Read this article at

Abstract

BACKGROUND

AIM

METHODS

RESULTS

CONCLUSION

Related collections

SICOT-J (Orthopedic surgery and traumatology)

Most cited references 28

Hospital volume and mortality for 25 types of inpatient treatment in German hospitals: observational study using complete national data from 2009 to 2014

Risk management: extreme honesty may be the best policy.

Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 488