title: Reason for Lawsuit in Spinal Cord Injury Affects Final Outcome.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To review past cases and analyze them to determine whether reason for lawsuit led to a defense versus plaintiff verdict when patients sustain spinal cord injury. Secondary objectives included analyzing demographic factors and monetary awards for plaintiff verdicts and settlements.
  
  
  BACKGROUND
  Evaluating malpractice cases could provide valuable information for the physician who has been sued by a patient. Previous studies about litigation and spine have been focused on medical tort reform and not on the reasons for litigation and lawsuit outcome.
  
  
  METHODS
  A large national medicolegal research service for civil and criminal court called "VerdictSearch" was queried for "spinal cord injury" between the years 2000 and 2010. Reason for lawsuit separated into 2 groups, error in diagnosis (n = 48), and error in treatment (n = 25). The anatomical region, outcome, cost, and job for sued health care workers recorded for each lawsuit.
  
  
  RESULTS
  Compared with physicians who were sued for errors in diagnosis, those sued for an error of treatment had a relative risk of 2.69 (95% confidence interval, 1.40-5.16) to receive a defense verdict (P = 0.003). There were no significant differences in demographic information, including age, sex, occupation type, and level of injury. Among specialties, surgeons had the highest number of suits. The median value for each anatomic area was highest in thoracic spine ($1.90 million), followed by cervical spine ($1.80 million) and lumbar spine ($0.750 million), although there were no statistical differences between the 3 areas (P = 0.301). The median monetary award for a plaintiff verdict was higher than that for a settlement ($2.90 million, interquartile range: 1.50-12.5 million vs. $1.45 million, interquartile range: 1.00-2.90 million, P = 0.008).
  
  
  CONCLUSIONS
  Physicians are more likely to successfully defend a lawsuit for an error in treatment than for an error in diagnosis. The key to increase the success of defending a lawsuit in regard to spinal cord injury is to avoid delayed and incorrect diagnosis.
  
  
  METHODS
  N/A.
authors.affiliation: *Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, CA; and †Moody Air Force Base, Valdosta, GA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Quigley
authors.forename: Yusuf T
authors.initials: YT
authors.lastname: Akpolat
authors.forename: Brent D
authors.initials: BD
authors.lastname: Forrest
authors.forename: Montri D
authors.initials: MD
authors.lastname: Wongworawat
authors.forename: Wayne K
authors.initials: WK
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D003951:Diagnostic Errors / Q000191:economics / Q000331:legislation & jurisprudence; D004651:Employment; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence*; D019300:Medical Errors / Q000191:economics / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D013904:Thoracic Vertebrae