title: Malodorous consequences: what comprises negligence in anosmia litigation?
abstract: BACKGROUND
  Our objectives were to evaluate factors raised in malpractice litigation in which plaintiffs alleged that physician negligence led to olfactory dysfunction.
  
  
  METHODS
  We analyzed publically available federal and court records using Westlaw, a widely used computerized legal database. Pertinent jury verdicts and settlements were comprehensively examined for alleged causes of malpractice (including procedures for iatrogenic causes), defendant specialty, patient demographics, and other factors raised in legal proceedings.
  
  
  RESULTS
  Of 25 malpractice proceedings meeting inclusion criteria, 60.0% were resolved for the defendant, 12.0% were settled, and 28.0% had jury-awarded damages. Median payments were significant ($300,000 and $412,500 for settlements and awards, respectively). Otolaryngologists were the most frequently named defendants (68.0%), with the majority of iatrogenic cases (55.0%) related to rhinologic procedures. Associated medical events accompanying anosmia included dysgeusia, cerebrospinal fluid leaks, and meningitis. Other alleged factors included requiring additional surgery (80.0%), unnecessary procedures (47.4% of iatrogenic procedural cases), untimely diagnosis leading to anosmia (44.0%), inadequate informed consent (35.0%), dysgeusia (56.0%), and psychological sequelae (24.0%).
  
  
  CONCLUSIONS
  Olfactory dysfunction can adversely affect quality of life and thus is a potential area for malpractice litigation. This is particularly true for iatrogenic causes of anosmia, especially following rhinologic procedures. Settlements and damages awarded were considerable, making an understanding of factors detailed in this analysis of paramount importance for the practicing otolaryngologist. This analysis reinforces the importance of explicitly including anosmia in a comprehensive informed consent process for any rhinologic procedure.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Mauro
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: Michael
authors.initials: M
authors.lastname: Setzen
authors.forename: Michael A
authors.initials: MA
authors.lastname: Carron
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Folbe
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D007258:Informed Consent; D007603:Jurisprudence; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D000857:Olfaction Disorders / Q000453:epidemiology* / Q000209:etiology; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012225:Rhinoplasty / Q000009:adverse effects; D013315:Stress, Psychological / Q000209:etiology; D014481:United States
keywords: anosmia; hyposmia; informed consent; litigation; malpractice; negligence; rhinologic; rhinology