Neurosurgery in the law court.
OBJECTIVE
The evident rise in the number of neurosurgical malpractice and the apparent lack of adequate training in neurosurgery patient management are discussed. However, alongside neurosurgeons, neurosurgical malpractice claims involve also physicians from primary to specialist care, particularly those attending neurosurgical patients in emergency rooms. Some pathologies and disputed treatments are described.


METHODS
The case series includes 138 medical malpractice lawsuits examined over a 10-year period (1992-2002). The pathologies for which disputed treatment led to malpractice lawsuit as well as their frequency are presented.


RESULTS
Of the total 138 lawsuits examined, 38 did not involve professional health care workers, whereas the remaining 100 cases involved: neurosurgeons (48 cases); other specialist or primary physicians (51 cases); nursing staff (1 case). These malpractice lawsuits and the relevant pathologies are examined in detail.


CONCLUSIONS
On the basis of personal experience, some considerations and recommendations are suggested for the clinical practice.
De Santis
A
A
Neurosurgey Unit, L. Sacco Department of Clinical, Sciences University of Milan, O. Galeazzi Institute, Milan, Italy.
D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence* / Q000639:trends; D017586:Diskectomy / Q000009:adverse effects; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence / Q000639:trends; D004638:Emergency Treatment / Q000009:adverse effects; D004827:Epilepsy / Q000175:diagnosis; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D007258:Informed Consent / Q000592:standards; D019586:Intracranial Hypertension / Q000175:diagnosis; D007558:Italy; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000639:trends; D009026:Mortality / Q000639:trends; D009493:Neurosurgery / Q000331:legislation & jurisprudence* / Q000639:trends; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D009732:Nursing Care / Q000592:standards; D010353:Patient Education as Topic / Q000592:standards; D010821:Physicians, Family / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000009:adverse effects / Q000331:legislation & jurisprudence*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013119:Spinal Cord Injuries / Q000175:diagnosis; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis; D016896:Treatment Outcome