title: Medicolegal aspects of the orthopaedic care for shoulder injuries.
abstract: The medicolegal aspects of orthopaedic care increasingly are becoming an important focus of physicians. Because of the rarity of publications on the subject, I will examine medical litigation in orthopaedics, specifically in regards to shoulder injuries. There are several reasons for recent increases in malpractice litigation. Increased orthopaedic specialization and advanced technologies have raised patient expectations while the media have informed patients of the potential financial rewards of litigation. I will discuss three cases of litigation regarding shoulder injuries including reasons for malpractice and what can be done to avoid it. In Case 1 I examine an implant failure of a rotator cuff repair. The failure was caused by a manufacturing error; therefore, the importance of being familiar with the equipment and the companies that a physician deals with is emphasized in this case. Case 2 is another failed rotator cuff repair; this litigation stemmed from poor patient selection and a lack of preoperative patient-physician communication. Finally, Case 3 involved retained hardware, a surgical mistake that often results in a substantial settlement because it is considered indefensible. These cases highlight the potential for malpractice and can be applied more broadly to all branches of orthopaedics. Most litigation, however, can be avoided with careful diagnostic procedures, greater experience with equipment, and better communication.
authors.affiliation: Duke University Medical Center, Box 3615, Durham, NC 27710, USA. higgi011@mc.duke.edu
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Higgins
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007595:Joint Prosthesis; D016365:Liability, Legal; D008279:Magnetic Resonance Imaging; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000331:legislation & jurisprudence* / Q000379:methods; D011475:Prosthesis Failure; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012494:Sampling Studies; D000070599:Shoulder Injuries; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000601:surgery