title: Epistaxis: the factors involved in determining medicolegal liability.
abstract: BACKGROUND
  The purpose of this study was to examine litigation involving epistaxis and analyze factors that determine liability.
  
  
  METHODS
  Jury verdicts and settlements regarding cases involving epistaxis were gathered utilizing the Westlaw database. Factors involved in litigation gathered included demographics, defendant specialty, procedure, alleged cause of malpractice, outcome, monetary award, and other variables.
  
  
  RESULTS
  A total of 26 cases were analyzed. The majority of cases (57.7%) were decided in favor of the plaintiff or settled out of court. Total awards amounted to $24,501,252. Average awards for cases decided in favor of the plaintiff were $2,260,893 and ranged from $499,845 to $9,022,643. Settlements averaged $1,084,375 and ranged from $300,000 to $3,800,000. Common causes of malpractice encountered included delay in diagnosis, complications from medical procedures, and failure to recognize complications in a timely manner.
  
  
  CONCLUSIONS
  Contrary to previous reports analyzing malpractice for varying medical procedures and complications, litigation in epistaxis is more commonly resolved in favor of the plaintiff or resolved through out-of-court settlements. Substantial financial awards and therapeutic complications from blindness to death make epistaxis a candidate for litigation. Of importance from a medicolegal stand is the fact that 30.8% (8) of the patients involved in epistaxis litigation died, either from complications of therapy or from experiencing epistaxis as a complication of another procedure/pathology. Using necessary diagnostic imaging, ensuring proper management techniques, and recognizing complications in a timely manner can serve to limit legal liability and enhance patient safety.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Mohemmed N
authors.initials: MN
authors.lastname: Khan
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Blake
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vazquez
authors.forename: Michael
authors.initials: M
authors.lastname: Setzen
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004844:Epistaxis; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: bloody nose; epistaxis; epistaxis treatment; liability; litigation; malpractice; nasal packing; nose bleed; nosebleed