Meningitis and legal liability: an otolaryngology perspective.
OBJECTIVE
Meningitis is a potential complication in otolaryngologic procedures and conditions. Severe sequelae make understanding factors involved in relevant malpractice litigation critical. We analyze pertinent litigation for awards, outcomes, patient demographic factors, and other alleged causes of malpractice.


METHODS
Pertinent jury verdict and settlement reports were examined using the Westlaw legal database (Thomson Reuters, New York, NY).


RESULTS
Twenty-three cases (60.5%) involved non-iatrogenic injuries, including inadequate treatment or failure to diagnose sinusitis or otitis media, while 15 (39.5%) involved iatrogenic cases, mostly rhinologic procedures. 36.8% of cases were resolved for the defendant, 28.9% with juries awarding damages, and 34.2% with settlements. Although not statistically significant, mean damages awarded were higher than settlements ($2.1 vs. 1.5M, p=0.056), and cases involving pediatric patients were more likely to be resolved with payment than those with adult litigants (80.0% vs. 52.2%, p=0.08 respectively). Other frequent alleged factors included permanent deficits (63.2%), requiring additional surgery (41.1%), death (34.2%), cognitive deficits (21.2%), deafness (15.8%), and inadequate informed consent (33.0% of iatrogenic cases).


CONCLUSIONS
Practitioners facing litigation related to meningitis may wish to consider these findings, notably for cases involving death or permanent functional deficits, as cases with out of court settlements tended to be resolved with lower payments. Cases involving misdiagnosis may be more likely to be resolved with payment compared with iatrogenic cases. By understanding the issues detailed in this analysis and including them in the informed consent process for patients undergoing rhinologic and otologic procedures, otolaryngologists may potentially improve patient safety and decrease liability.
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA.
Peter F
PF
Svider
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA.
Danielle M
DM
Blake
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA.
Kiren P
KP
Sahni
Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
Adam J
AJ
Folbe
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA.
James K
JK
Liu
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA.
Soly
S
Baredes
Department of Otolaryngology-Head and Neck Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; Department of Neurological Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Rutgers, New Jersey Medical School, Newark, NJ, USA. Electronic address: jean.anderson.eloy@gmail.com.
Jean Anderson
JA
Eloy
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008581:Meningitis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D055815:Young Adult