Medical Malpractice Litigation Involving Arteriovenous Malformations of the Central Nervous System

To comprehensively analyze malpractice claims relating to arteriovenous malformations.

Westlaw and LexisNexis databases were cross-referenced to obtain a comprehensive list of medical malpractice lawsuits related to arteriovenous malformations. The initial search yielded 147 results, of which 78 were considered eligible for analysis.

Plaintiff age was reported in 16 cases (mean age 30.9 ± 19.9 years). In 53 cases, the location of the lesions was reported: 38 (90.9%) were intracranial, and 15 (28.3%) were spinal. The main complaints were medical error (34 cases, 43.6%), failure to diagnose (33 cases, 42.3%), failure to treat (20, 25.6%), misdiagnosis (7 cases, 9.0%), lack of informed consent (7 cases, 9.0%), and other causes (11 cases, 14.1%). The medical specialties most commonly involved were neurosurgery (22 cases, 34.4%), radiology (16 cases, 25.0%), and neurology (10 cases, 15.6%). Neurosurgeons were more frequently sued than neurologists (P = 0.01) but not radiologists (P = 0.25). The court rulings included in favor of the defendant in 23 cases (29.5%), in favor of the plaintiff in 6 cases (7.7%), a settlement in 27 cases (34.6%), mediation in 1 case (1.3%), and unknown/other in 21 cases (26.9%). Rulings in favor of the defendant (P = 0.0005) or settlements (P < 0.0001) were more frequent than rulings in favor of the plaintiff, but there was no difference in rulings in favor of the defendant compared with settlements (P = 0.69).

While the courts rule in favor of defendants more than plaintiffs, the time and psychological demands of litigation place a high burden on physicians.