title: A critical analysis of melanoma malpractice litigation: Should we biopsy everything?
abstract: The aim of this study was to evaluate factors raised in malpractice litigation related to the diagnosis and management of melanoma and to further assess issues impacting outcome.
  
  
  
  Retrospective chart review.
  
  
  
  The Westlaw legal database was searched for malpractice litigation resolved over the last 20 years relating to melanoma. Cases were evaluated for allegations, defendant specialty, outcome, and other issues raised.
  
  
  
  Of the 80 cases evaluated, 49% were resolved in the defendants' favor. In greater than 80% of cases, there was alleged misdiagnosis. In 35% of cases, the patient had expired secondary to melanoma at the time of litigation. There was no statistical difference in payments upon comparison of cases with and without mortality. A greater proportion of cases with dermatologists and pathologists as defendants involved alleged misdiagnosis. The most common locations for melanoma were the extremities and the head-and-neck region, at 32.5% and 22.5%, respectively. Location did not significantly impact the outcome of cases.
  
  
  
  Malpractice litigation relating to melanoma involves numerous physicians, including dermatologists, pathologists, and otolaryngologists. Alleged misdiagnosis of a pigmented lesion was the most common cause of litigation and involved physicians from numerous specialties. Patients who were misdiagnosed had a significantly higher likelihood of having active disease at the time of litigation. Ultimately improved methods of detecting concerning pigmented lesions need to be developed. Factors such as death and poor cosmetic outcome did not significantly impact litigation outcome.
  
  
  
  NA Laryngoscope, 127:134-139, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.
authors.forename: Hani M
authors.initials: HM
authors.lastname: Rayess
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.
authors.forename: Amar
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A.
authors.forename: S Naweed
authors.initials: SN
authors.lastname: Raza
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A.|Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, U.S.A.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Shkoukani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, U.S.A.
authors.forename: Giancarlo F
authors.initials: GF
authors.lastname: Zuliani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.|Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Carron
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008511:Medicine; D008545:Melanoma / Q000175:diagnosis* / Q000628:therapy*; D010036:Otolaryngology / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D014481:United States
keywords: Melanoma; malpractice litigation; medical malpractice; medicolegal