Complications and legal outcomes of tonsillectomy malpractice claims

To review malpractice cases involving complications following tonsillectomy.

Retrospective analysis at a tertiary medical center of jury verdict reports within the LexisNexis (Dayton, OH) database submitted after tonsillectomy malpractice cases.

The LexisNexis MEGA Jury Verdicts and Settlements database was reviewed from 1984 through 2010 for complications resulting from tonsillectomy. Data including year of case, surgical complication, injury, case result, and judgment awarded were collected and analyzed.

One hundred seventy-eight reports met inclusion criteria and were reviewed. Postoperative bleeding was the most common complication (33.7%), followed by anoxic events (16.9%), and impaired function (15.7%). Patient death occurred in 40.4% of reports and was most frequently associated with postoperative bleeding (54.2%), followed by anoxic events (18.1%), and postoperative medication issues (16.7%). Monetary awards were available in 24.7% of reports. Anoxic event was noted to have the highest median award at $3,051,296, followed by postoperative medication at $950,000.

Tonsillectomy carries a large amount of risk from a malpractice standpoint. Postoperative bleeding is the complication most commonly associated with malpractice claims, but may not carry the greatest overall risk from a patient care or monetary standpoint. Hypoxic and anoxic events, although less common, appear to carry more morbidity for the patient and are associated with greater settlements and judgments in malpractice claims. Tonsillectomy continues to carry a significant mortality risk, albeit infrequent, and a high level of vigilance should be employed to help reduce these risks.