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Study cites factors linked to lawsuits for distal radius fracture care
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CHICAGO — The results of a recently presented study note an increase in malpractice litigation rates for distal radius fracture management. It indentifies malunion, physician gender and poor doctor/patient relationships among the risk factors for these lawsuits.
“Severe malunions in a younger, working population is the major feature of distal radius malpractice litigation,” study presenter Peter H. DeNoble, MD, said. “Poor doctor/patient relationships can amplify a poor clinical outcome, possibly resulting in a lawsuit. Older surgeons and those with lack of [American Board of Orthopaedic Surgery] ABOS certification were significantly more likely to make an indemnity payment. Malpractice rates for distal radius fracture management, particularly for operative management, are on the rise.”
Peter H. Noble
DeNoble and the researchers requested closed claims data on distal radius fracture medical malpractice lawsuits from a medical liability insurer in New York state from 1981 to 2005. They pulled demographic, clinical and legal information from the database and used the New York Statewide Planning and Research Cooperative System and the 2008 American Academy of Orthopaedic Surgeons (AAOS) census data to calculate the incidence rates of alleged malpractice.
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“Distal radius fractures are the most common source of litigation among hand and wrist claims,” DeNoble said.
Although the investigators found a 0.04% rate of distal radius malpractice lawsuits, they discovered the rate increased over time. Most patients (97%) sued due to fracture malunion regardless of treatment method, DeNoble said, and 18% of nonoperatively treated patients involved in a malpractice suit were followed up with weekly radiographs for the first 3 weeks. “Interpersonal issues were also a predominant theme for many of these cases,” DeNoble said. Many defendants had an average of nine career lawsuits and were male; 6% received fellowship training in hand surgery. Those without a board certification were more likely to pay indemnities, with 38 of 70 cases ending in indemnity payments. Out of 35 pre-trial settlements, according to the study abstract, the mean indemnity cost was $167,449.
Reference:
DeNoble PH, Marshall AC, Barron QA, et al. Malpractice in distal radius fracture management: An analysis of closed claims. Paper #24. Presented at the American Society for Surgery of the Hand 2012 Annual Meeting. Sept. 6-8. Chicago.
Disclosure: DeNoble has no relevant financial disclosures.
