C.t. Grayson, MD, MPH, Erik Criman, MD, Lindsay Cefalu, MD, Erik Roedel, MD, Christopher Yheulon, MD. Tripler Army Medical Center
Objectives: Practitioners in high-risk specialties, such as general surgery, are estimated to have a 99% likelihood of facing litigation over the course of their career. Our group sought to quantify the litigation patterns in inguinal hernia repair operations, a commonly performed surgery in this specialty.
Methods: Cases were retrieved by searching the WESTLAW database from 1991 through 2016 using the search terms “inguinal hernia” OR “inguinal herniorraphy” OR “inguinal hernioplasty” and “medical malpractice.” Data was compiled on the demographics of the patient, operative case details, nature of injury, legal allegations, verdicts, and indemnities.
Results: 46 cases met inclusion criteria and were selected for review. Verdicts for the defendant predominated (67%). The average plaintiff’s monetary award for a plaintiff verdict or settlement was $1.21 million (median $500,000). The most frequent legal argument was improper performance (n=35, 76%), followed by failure of informed consent (n=14, 30%). The most common complications were nerve/chronic pain (n=20, 45%) and testicular damage (n=10, 23%). No association was discovered between case outcome and patient gender (p=.231) or age (p=.899). Case outcome was not different between open and laparoscopic repairs (p=.722). Patient mortality was not associated with case outcome (p=.311). There was no chronological trend in case outcome or award amount. Settlement award amounts were not significantly different then plaintiff awards (p=.332).
Conclusion: Successful litigation following inguinal hernia surgery was relatively infrequent – only 21.7% – with an additional 10.9% resulting in settlement awards. Case outcome in litigation for hernia surgery was not predicted by patient demographics, type of procedure, or type of complication in this dataset. The most common alleged injuries after surgery were chronic pain/neuralgia, followed by testicular damage.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79642
Program Number: MSSP01
Presentation Session: Military Poster (Non CME)
Presentation Type: MSSPoster