Sociological and Medical Factors Influence Outcomes in Facial Trauma Malpractice

Publication date: Available online 15 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Alexander M. Mozeika, Devika Sachdev, Rijul Asri, Nicole Farber, Boris Paskhover

Abstract

PURPOSE

Medical error within the United States carries significant economic and safety costs, both of which manifest in a large number of malpractice suits filed each year. The aim of this study is to characterize the various sociological and medical factors that influence malpractice suits occurring from cases of facial trauma.

STUDY DESIGN

Retrospective cohort study of defendant data from facial trauma malpractice cases extracted from the Westlaw database, a database composed of representative federal litigations. Study variables of interest include geographical region, type of trial, injury category, and provider specialty, which were analyzed for impact on initial and final legal decisions. Descriptive statistics, Pearson's chi-squared testing, and Fisher's t-testing were performed using SPSS.

RESULTS

Of the 69 defendants, with 76.8% being male and 23.2% being female, and with an age range of 17 to 57, which resulted from 53 claims, 12 (17.4%) involved plastic surgeons and 10 (14.5%) involved emergency physicians. The majority of complaints were made up of inadequate care that deviated from treatment standards (32 [46.4%]) and delayed diagnosis (24 [34.8%]). Of the delayed diagnosis, 14 patients had x-ray imaging performed. Geographical location of the claim was statistically significant—the Midwest upheld 40% of complaints (p=0.007) and the South dismissed 91.4% (p=0.027).

CONCLUSION

The impact of sociological factors, including geographic region, informed consent, and cosmesis, and medical factors, such as delayed diagnosis and deviation from standard of care, in facial trauma litigation were found to be incongruent with previous studies describing the medicolegal influences in the field of facial plastics. This analysis provides greater insight to surgical practitioners across subspecialty disciplines regarding the potential legal implications of malpractice.

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