title: Medical malpractice and hernia repair: an analysis of case law.
abstract: BACKGROUND
  Litigation analysis and clinician education are essential to reduce the number and cost of malpractice claims. This study evaluates the clinical characteristics and legal outcomes of medical malpractice litigation initiated by patients having undergone a hernia repair operation.
  
  
  METHODS
  Published civil suits were obtained from a legal database for state and federal decisions constituting case law. The published material includes information on defendants, plaintiffs, allegations, outcomes, and a variety of legal issues. A retrospective review of 44 published cases from 25 states was performed.
  
  
  RESULTS
  Complications were present in 20 of 44 (45%) suits, four (9%) of which were because of infection. Death occurred in five (11%) cases, and failure to obtain informed consent was alleged in seven (16%) of the suits. Retained foreign bodies were present in 7 of the 44 (16%) suits. Other allegations included incorrect surgical technique, insufficient need for surgery, and emotional distress. Most (64%) patients initiating malpractice litigation were male, and inguinal, hiatal, and ventral hernia repairs account for 39%, 27%, and 14% of cases, respectively. Most suits (40%) were initiated in Southern states. Surgical mesh was indicated in 5 of 44 (11%) suits but four of five were unrelated to the suit. One patient initiated litigation because of the fact that the surgeon did not use mesh during surgery, which was discussed preoperatively during the informed consent. The court ruled in favor of the plaintiff in 12 of 44 (27%) suits, with compensation ranging from roughly $19,000 to $8,000,000. Louisiana and New York had six and seven suits each, which appears disproportionate given their respective populations.
  
  
  CONCLUSIONS
  Complications and death resulting from alleged clinical negligence play a significant role in both the initiation and the outcome of malpractice litigation. Retained foreign bodies and lack of informed consent account for roughly one-third of malpractice litigation associated with hernia repairs. Many of these suits may be avoided with proper patient education and documentation of such along with standard operative preventative measures.
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Walters
authors.forename: Kristian T
authors.initials: KT
authors.lastname: Dacey
authors.forename: Alla Y
authors.initials: AY
authors.lastname: Zemlyak
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lincourt
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D005260:Female; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008318:Malpractice; D012189:Retrospective Studies