Analysis of in court malpractice litigation following pancreatic surgery

Pancreatic operations are technically complex with a significant risk of morbidity and mortality. Analysis of litigation following surgery can disclose avoidable errors.

Two legal databases, Westlaw and Lexis Nexis, were queried for jury verdicts, settlements and appeal cases in the United States related to pancreatic surgery and malpractice between 1980 and 2020.

Thirty-four cases were analyzed. Pancreaticoduodenectomy (n = 22, 65%) was the most common procedure litigated. Claims most commonly involved malpractice in the postoperative (n = 16) setting. The most common claims were failure to diagnose or treat postoperative complications (n = 16), lack of informed consent (n = 9), and wrongful indication for surgery (n = 8). Seven cases involved incorrect diagnosis of pancreatic cancer. Attending surgeons were the main provider named in the medical malpractice claim in 25 (74%) of the cases. Resident surgeons were named in 5 cases (15%). Half of the cases (n = 17) involved patient deaths. The court ruled in favor of the defendant in 75% of the cases, and the plaintiff in 12.5%. Median payout for settlements and plaintiff verdicts was 783,304 USD (interquartile range (IQR) 1,034,046). Mean time from incident to final disposition was 6.4 years (±3.3).

Obtaining an accurate preoperative diagnosis may decrease malpractice litigation following pancreatic surgery. By raising awareness to unsafe practices and identifying vulnerable periods of care, these data may serve to enhance provider performance as well as improve patient safety.