title: Adverse events in carotid endarterectomy from a medicolegal perspective.
abstract: OBJECTIVE
  Characterize factors raised in carotid endarterectomy litigation.
  
  
  METHODS
  Outcomes, alleged causes of malpractice, and other factors were evaluated.
  
  
  RESULTS
  Of the 37 verdicts and settlements, defendants were not liable in 25 (67.5%) cases. Frequently reported complications included stroke (51.3%) and hypoglossal nerve injury (27.0%), with other complications including airway compromise, vocal cord injury, and death. No cases reported myocardial infarction. Cerebral monitoring was mentioned in 2 cases, while inadequate informed consent, delayed diagnosis, and requirement of additional surgery were alleged in numerous instances. Settlements and jury awards averaged US$895 833 and US$1.53 million, respectively.
  
  
  CONCLUSIONS
  Stroke and hypoglossal nerve injury are the most frequently litigated complications, and mean damages awarded were considerable. Knowledge of issues raised in our analysis may be included in a comprehensive consent process, potentially minimizing liability and improving patient safety.
authors.affiliation: Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA psvider@gmail.com.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.affiliation: Department of Surgery, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Gian-Paul
authors.initials: GP
authors.lastname: Vidal
authors.affiliation: Department of Surgery, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Zumba
authors.affiliation: The University of Michigan Law School, Ann Arbor, MI, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Mauro
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Haser
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Graham
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Saum
authors.initials: S
authors.lastname: Rahimi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D035881:Compensation and Redress; D057210:Delayed Diagnosis / Q000331:legislation & jurisprudence; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000191:economics / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D016365:Liability, Legal / Q000191:economics; D008297:Male; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence*; D019300:Medical Errors / Q000191:economics / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D061214:Patient Safety; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology* / Q000601:surgery; D012086:Reoperation / Q000331:legislation & jurisprudence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: carotid endarterectomy; liability; litigation; malpractice; medicolegal; negligence