Thyroid surgery malpractice claims: Emerging trends and future directions

http://www.ncbi.nlm.nih.gov/pubmed/22431167

Head Neck. 2012 Mar 20. doi: 10.1002/hed.21970. [Epub ahead of print]

Verdicts on malpractice claims after thyroid surgery: Emerging trends and future directions.

Dralle H, Lorenz K, Machens A.

Source

Department of General, Visceral and Vascular Surgery, University Hospital and Medical Faculty, University of Halle-Wittenberg, Halle/Saale, Germany. henning.dralle@uk-halle.de.

Abstract

BACKGROUND:

Few investigations have addressed malpractice litigation after thyroid surgery. The purpose of this medico-legal review was to provide a more comprehensive picture of medico-legal trends in thyroid surgery.

METHODS:

Reviewed were all expert opinions on claims of malpractice after thyroid surgery, commissioned between 1995 and 2010 at 1 tertiary center, and their corresponding verdicts.

RESULTS:

Forty-three of 75 malpractice claims involved recurrent laryngeal nerve (RLN) palsy (21 unilateral and 22 bilateral palsies), with a 45% tracheostomy rate for bilateral RLN palsy. Twenty-one claims concerned permanent hypoparathyroidism. Since 2007, intraoperative nerve monitoring (IONM) has become the subject of pleading in 4 of 7malpractice claims involving unilateral or bilateral RLN palsy. In none of these cases did IONM follow international standards, resulting in 3 plaintiff verdicts.

CONCLUSION:

The growing appreciation that standardized IONM can prevent bilateral RLN palsies after signal loss on the initial side of resection may become increasingly relevant to malpractice litigation.