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

Head Neck. 2012 Nov;34(11):1591-6. doi: 10.1002/hed.21970. Epub 2012 Mar 20.

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 7 malpractice 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.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Malpractice / statistics & numerical data*
  • Medical Errors / statistics & numerical data*
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Thyroid Gland / surgery*
  • Thyroidectomy / adverse effects*
  • Thyroidectomy / economics
  • Young Adult