Cancer of the oral cavity and medical malpractice.
OBJECTIVE
To analyze malpractice litigation initiated by patients with cancer of the oral cavity as a result of allegations concerning their diagnosis and treatment.


METHODS
Retrospective review.


METHODS
Jury verdict reviews from 1984 to 2000 were obtained from a computerized legal database and analyzed. Reviews compile pertinent data on defendants, plaintiffs, verdict outcomes, indemnity payments, and allegations of wrongdoing and provide case summaries. Fifty cases from 21 of all 50 states were obtained. Data were entered into a spreadsheet for analysis.


RESULTS
Overall, a young age (mean age, 45 y) and poor oncological outcome (47% dead) were seen. The younger age group (<47 y) had a better outcome (65% without disease), were more often misdiagnosed (19%), won awards (60%), and had higher awards (average award, $755,824) as compared with those older than 47 years of age, who had 39% without disease, 0% misdiagnosed, and 52% who won awards that were less, on average, at $495,417. Failure to diagnose the cancer was alleged, overall, in 43 of 50 cases (86%), and in general practice, dentists, and otolaryngologist in 100%, 85%, and 89%, respectively. Suits alleging a delay in diagnosis of less than 3 months were defendant verdicts in 86%, and of more than 3 months, in 40%. Failures to perform biopsy and to refer were common allegations.


CONCLUSIONS
Young age of patients bringing litigation is seen in patients with oral cancer. These patients frequently have poor oncological outcomes. Risk management goals to prevent delays in diagnosis may help prevent subsequent litigation.
Lydiatt
Daniel D
DD
Department of Otolaryngology, University of Nebraska Medical Center and Methodist Cancer Center, Omaha 68198-1225, USA.
D000328:Adult; D000367:Age Factors; D001706:Biopsy; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007351:Insurance, Liability / Q000331:legislation & jurisprudence; D007883:Legislation, Medical; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010348:Patient Care Team / Q000331:legislation & jurisprudence; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D012189:Retrospective Studies; D013038:Specialization; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States