title: Medication associated with hearing loss: 25 years of medical malpractice cases in the United States.
abstract: OBJECTIVE
  Many medications have the potential for ototoxicity. To potentiate management of this risk, this study examines malpractice litigation trends of lawsuits involving hearing loss associated with medication use. As experts in hearing loss, it may benefit otolaryngologists to be familiar with this information.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  All US civil trials.
  
  
  METHODS
  Court records of legal trials from 1987 to 2012 were obtained from 2 major computerized databases. Data were compiled on the demographics of the defendant and plaintiff, use of otolaryngologists as expert witnesses, medication used, legal allegations, verdicts, and judgments.
  
  
  RESULTS
  Forty-six unique cases met inclusion criteria and were selected for review. Antibiotics (72%), specifically aminoglycosides (47%), were the most common medications cited as causing hearing loss. Eleven (22%) cases were resolved through a settlement before a verdict was reached. Verdicts in favor of the plaintiffs (37%) were awarded an average of $1,134,242. Pediatric patients were more likely to have outcomes in their favor (P = .03) compared to adults. Of the cases found in favor of the plaintiff, the most common reasons cited were inappropriate medication, dose, or duration (59%); failure to properly monitor (39%); and failure to choose a less toxic medication (18%).
  
  
  CONCLUSIONS
  Physicians must be aware of the potential effects of the medications they prescribe. An understanding of potential drug interactions, proper monitoring, and appropriate substitution with less toxic medications are important to improve patient care. Analyzing litigation trends may be used to prevent future lawsuits and improve physician awareness.
authors.affiliation: Tripler Army Medical Center, Department of Otolaryngology-Head & Neck Surgery, Honolulu, Hawaii, USA douglas.s.ruhl.mil@mail.mil.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Ruhl
authors.affiliation: Tripler Army Medical Center, Department of Otolaryngology-Head & Neck Surgery, Honolulu, Hawaii, USA.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Cable
authors.affiliation: Tripler Army Medical Center, Department of Otolaryngology-Head & Neck Surgery, Honolulu, Hawaii, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Martell
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D005839:Gentamicins / Q000009:adverse effects / Q000627:therapeutic use; D034381:Hearing Loss / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007603:Jurisprudence; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States
chemical_list: D005839:Gentamicins; D002945:Cisplatin
keywords: hearing loss; medical malpractice; medication; ototoxicity