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Wrong disc space level surgery: medicolegal implications
Robert Goodkin1, Lewis L Laska
1Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington 98195, USA.
Background:
Operating the wrong disc level for herniated disc disease is a rarely reported complication. However, it is considered by many a breach in the standard of care. It is not unusual for litigation to result. Sixty-nine cases of wrong disc space level surgery were identified; 68 cases were the subject of lawsuits.
Methods:
Sixty-five lawsuit outcomes were published in a national monthly newsletter of malpractice cases, Medical Malpractice Verdicts, Settlements and Experts. Two cases came from medicolegal review, one case from a news article, and one case for which no claim was made.
Results:
Thirty-seven cases were settled. A plaintiff verdict was rendered in 18 cases and a defense verdict in 13 cases (42% of the cases that were decided by a jury).
Conclusions:
The authors summarize steps to reduce the incidence of this misadventure. The authors recommend that the patient be advised of this potential and the patient be informed of the risk factors when special circumstances exist.
Insights
Operating on the wrong disc level during spine surgery is a serious complication leading to litigation. Most cases identified were part of lawsuits, highlighting the need for improved surgical safety protocols.
Area of Science:
- Neurosurgery
- Spine Surgery
- Medical Malpractice
Background:
- Wrong-level disc surgery is a rare but significant complication in treating herniated disc disease.
- This surgical error is often viewed as a breach of the standard of care, frequently resulting in legal action.
- A high proportion of identified wrong-level surgery cases (68 out of 69) were involved in lawsuits.
Purpose of the Study:
- To analyze the outcomes of litigation related to wrong-level disc surgery.
- To identify the frequency and resolution of legal cases stemming from surgical errors in disc level identification.
- To provide insights into the medicolegal implications of operating on the incorrect disc level.
Main Methods:
- Review of 69 identified cases of wrong disc space level surgery.
- Analysis of 65 lawsuit outcomes published in "Medical Malpractice Verdicts, Settlements and Experts."
- Inclusion of cases from medicolegal reviews, news articles, and one case without a formal claim.
Main Results:
- Out of 65 litigated cases, 37 were settled.
- Plaintiffs received favorable verdicts in 18 cases.
- Defendants won 13 cases, representing 42% of jury-decided cases.
Conclusions:
- The study highlights the prevalence of litigation following wrong-level disc surgery.
- Recommendations include informing patients about potential risks and specific risk factors.
- Implementing enhanced measures is crucial to minimize the occurrence of this surgical misadventure.
