title: Malpractice in treatment of sinonasal disease by otolaryngologists: a review of the past 10 years.
abstract: OBJECTIVE
  Sinonasal disease is a common condition treated by otolaryngologists. Malpractice in this area is the most common litigation faced by otolaryngologists. This study analyzes malpractice in the treatment of sinonasal disease.
  
  
  METHODS
  Case series, review of legal records.
  
  
  METHODS
  Legal databases.
  
  
  METHODS
  Using 2 different computerized legal databases, the phrase medical malpractice was searched with terms related to sinonasal disease involving court cases in the past 10 years (2004-2013), yielding 26 cases. The cases were analyzed for pertinent data regarding plaintiffs, presenting complaint, practice setting, type of malpractice, resulting injury, result of verdict, and amount of reward or settlement.
  
  
  RESULTS
  Chronic sinusitis (42%) was the most common presenting symptom. Many cases included multiple types of alleged malpractice, with the most common being negligent technique (38%) and lack of informed consent (27%). The most common alleged injuries included cerebrospinal fluid leak, meningitis, nasal obstruction, and orbital trauma. Defendants prevailed in 13 of 18 cases in which outcomes were known, with mean award of $225,000 and mean settlement of $212,500. The cases won by plaintiffs were all in a private practice setting.
  
  
  CONCLUSIONS
  Otolaryngologists should be aware of the causes of malpractice litigation as it relates to treatment of sinonasal disease. Lack of informed consent continues to be a common allegation, and surgeons should ensure complete informed consent is obtained and well documented. A unified and complete database of medical malpractice cases is needed to allow for further analysis of specialty-related claims.
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA twinford@wakehealth.edu.
authors.forename: Tyler W
authors.initials: TW
authors.lastname: Winford
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Jordan L
authors.initials: JL
authors.lastname: Wallin
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Clinger
authors.affiliation: Bradley, Arant, Boult, Cummings, LLP, Jackson, Mississippi, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Graham
mesh_terms: D002908:Chronic Disease; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data*; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D013997:Time Factors; D014481:United States
keywords: medical malpractice; otolaryngology; sinonasal disease; sinus surgery