title: Necrotizing fasciitis and malpractice claims.
abstract: BACKGROUND
  Necrotizing fasciitis (NF) is an aggressive bacterial infection of the superficial fascia and subcutaneous tissues that is increasing in incidence. The high toll exacted by this illness provides a setting for malpractice claims.
  
  
  METHODS
  We reviewed 180 consecutive malpractice claims submitted by attorneys for medical expert review between 1987 and late 1997. Four cases involved NF.
  
  
  RESULTS
  Alleged failure to obtain timely surgical consultation was the basis for three claims, and alleged failure to prevent NF by proper nursing care was the basis for the fourth. Three cases were closed and one was settled.
  
  
  CONCLUSIONS
  The cornerstone of risk management for a clinical presentation compatible with NF is immediate surgical consultation, with other diagnostic steps a secondary consideration.
authors.affiliation: Veterans Affairs Medical Center, Hampton, VA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Fink
authors.forename: T K
authors.initials: TK
authors.lastname: Chaudhuri
authors.forename: H H
authors.initials: HH
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D003951:Diagnostic Errors; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000451:nursing / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice; D008875:Middle Aged; D011320:Primary Health Care