Medicolegal analysis of errors in diagnosis and treatment of surgical endocrine disease.
BACKGROUND
The medicolegal impact of adverse events in surgical endocrine disease has not been described previously. This study was undertaken to determine the causes, costs, and outcomes of endocrine malpractice litigation.


METHODS
Jury verdict reports from the U.S. civil court system from 1985 through 1991 were reviewed. Sixty-two malpractice cases were identified from 21 states.


RESULTS
The 62 cases were classified into three categories, totaling 63 adverse events: (1) complications (n = 34, 54%) from thyroid (n = 32, 51%) or parathyroid (n = 2, 3%) surgery; (2) delayed diagnosis (n = 22, 35%) of thyroid cancer (n = 11, 18%), adrenal tumors (n = 9, 14%), and hyperparathyroidism (n = 2, 3%); and (3) medical morbidity (n = 7, 11%) from radioactive iodine (n = 5, 8%) or from propylthiouracil (n = 2, 3%). Surgical injuries, mostly recurrent nerve injuries by general surgeons, accounted for the greatest number of cases and the highest cost of litigation.


CONCLUSIONS
Medical malpractice involving endocrine disease results in expensive litigation, a result of serious harm. Technical misadventures account for most cases, followed closely by delays in diagnosis. These data may aid design of risk prevention strategies in endocrine disease.
Kern
K A
KA
Department of Surgery, Hartford Hospital, Conn.
D003365:Costs and Cost Analysis; D003951:Diagnostic Errors; D004700:Endocrine System Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007256:Information Systems; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D008318:Malpractice; D011183:Postoperative Complications; D011441:Propylthiouracil / Q000009:adverse effects / Q000627:therapeutic use
D007457:Iodine Radioisotopes; D011441:Propylthiouracil