title: Protecting the most vulnerable: litigation from pediatric otolaryngologic procedures and conditions.
abstract: OBJECTIVE
  To identify allegations raised in litigation stemming from pediatric otolaryngologic procedures and conditions.
  
  
  METHODS
  Retrospective analysis of a legal database.
  
  
  METHODS
  The authors reviewed jury verdict and settlement reports on the WestlawNext database from 1994 to 2013 for cases involving pediatric plaintiffs and alleged negligence in otolaryngologic procedures and conditions.
  
  
  RESULTS
  Of the 78 cases included, 52.6% were resolved with a payment; aggregate payments exceeded $69 million, and median jury-awarded damages and settlements were $874,190 and $250,000, respectively. Adenotonsillectomy was the most commonly litigated procedure. Otolaryngologists were defendants in 42 (53.8%) cases, with pediatricians and anesthesiologists the next most commonly named defendants. Forty-six (59.0%) cases involved alleged negligence in operative management, whereas other factors included permanent injury (44.9%), misdiagnosis/failure to diagnose in a timely manner (41.0%), death (35.9%), and requiring additional surgery. Airway-related complications and allegedly permanent injuries significantly increased the size of payments. Awards were highest in cases with plaintiffs at 1 to 5-years of age and lowest among children older than 10 years of age.
  
  
  CONCLUSIONS
  Unique considerations specific to pediatric patients are involved in malpractice litigation, and damages awarded were considerable. By including the specific factors listed in this analysis in a comprehensive informed consent process, and recognizing concerns specific to this patient population, practitioners in multiple specialties may potentially reduce liability. Clear communication with parents is a critical component of this process.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rose
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.forename: Anthony
authors.initials: A
authors.lastname: Sheyn
authors.forename: Lila N
authors.initials: LN
authors.lastname: Meadows
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: James
authors.initials: J
authors.lastname: Coticchia
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Folbe
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence*; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D013517:Otorhinolaryngologic Surgical Procedures / Q000331:legislation & jurisprudence*; D010372:Pediatrics / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies
keywords: Pediatric otolaryngology; liability; litigation; medical malpractice; negligence