Medical malpractice of prostate brachytherapy.
OBJECTIVE
To summarize the basis for brachytherapy-associated legal complaints.


METHODS
The cases summarized here were those worked on by one author (KW) from 1992 through 2002. Summary information about cases is kept solely for the purpose of informing opposing counsel regarding past experience as a defendant or expert witness. No information summarized here is kept for medical research purposes. KW was the defendant in three cases, and an expert witness in the remaining 10 cases.


RESULTS
Eleven cases were initiated due to a prostatic-rectal fistula--an abnormal communication between the prostatic urethra and rectum formed because of breakdown of irradiated tissue. Of the cases not involving a fistula, one was initiated due to chronic urinary burning, and the other arose from a patient identification mix-up, such that the plaintiff was treated with the implant planned for another patient. The principal physician defendant(s), after pre-trial winnowing, was the radiation oncologist alone in eight cases and the radiation oncologist and the urologist in five cases. In no case was a urologist named as a defendant without the radiation oncologist. None of the eleven rectal fistula cases involved an egregious seed placement error. Instead, plaintiff attorneys typically claimed breach of standard for care for what most physicians would likely consider to be variations within the standard of care.


CONCLUSIONS
Prostate brachytherapists should brace themselves for the likelihood of more lawsuits. In addition to fistulas, plaintiff attorneys are likely to devise more bases for lawsuits in the future.
Elliott
Kathryn
K
School of Law, University of Washington, Seattle, WA, USA.
Wallner
Kent
K
Merrick
Gregory
G
Herstein
Paul
P
D001918:Brachytherapy / Q000009:adverse effects*; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D010820:Physicians / Q000331:legislation & jurisprudence; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000331:legislation & jurisprudence; D012003:Rectal Fistula / Q000209:etiology; D012189:Retrospective Studies; D014548:Urinary Fistula / Q000209:etiology