Sociological and Medical Factors Influence Outcomes in Facial Trauma Malpractice.

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

MATERIALS AND METHODS: This retrospective cohort study examined defendant data from facial trauma malpractice cases extracted from the Westlaw database, a database composed of representative federal litigations. Study variables of interest included geographic region, type of trial, injury category, and provider specialty, which were analyzed for impact on initial and final legal decisions. Descriptive statistics, Pearson χ2 test, and Fisher t test were performed using SPSS.

RESULTS: Of the 69 defendants (76.8% men and 23.2% women; age range, 17 to 57 yr), which resulted from 53 claims, 12 (17.4%) involved plastic surgeons and 10 (14.5%) involved emergency physicians. Most complaints consisted of inadequate care that deviated from treatment standards (32 [46.4%]) and delayed diagnosis (24 [34.8%]). Of delayed diagnosis cases, 14 patients had radiographic imaging performed. Geographic location of the claim was statistically significant-the Midwest upheld 40% of complaints (P = .007) and the South dismissed 91.4% (P = .027).

CONCLUSIONS: The impact of sociologic 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 facial plastic procedures. This analysis provides greater insight to surgical practitioners across subspecialty disciplines regarding the potential legal implications of malpractice.