Bladder exstrophy-epispadias complex related litigation: A legal database review

Area of Science:

• Urology
• Medical Malpractice Law
• Pediatric Surgery

Background:

• Bladder exstrophy-epispadias complex (BEEC) is a rare congenital condition requiring specialized surgical management.
• Litigation surrounding complex birth defects can impact patient care and provider practices.

Purpose of the Study:

• To analyze the landscape of medical malpractice litigation in the United States specifically related to bladder exstrophy-epispadias complex treatment.
• To identify common allegations, outcomes, and financial liabilities in BEEC-related malpractice cases.

Main Methods:

• A comprehensive search of two legal databases (Nexis Uni, WestLaw) was conducted for cases from 1948 to 2022.
• Search terms included variations of "bladder exstrophy," "cloacal exstrophy," "epispadias," and legal terms like "malpractice" and "negligence."
• Sixteen unique cases were identified, with six meeting the criteria for detailed medical and legal analysis.

Main Results:

• Six cases were analyzed, with urologists and pediatric urologists named in 50% of lawsuits.
• Allegations included surgical performance negligence (50%), primary closure issues (33%), and post-operative care (50%).
• Physicians prevailed in 60% of trials; one settlement was $500,000 and one monetary damage award was $1.3 million.

Conclusions:

• Malpractice litigation for BEEC treatment is infrequent, and outcomes generally favor medical providers.
• Financial liability arose from proven, avoidable negligence causing irreversible damage.
• Patients with BEEC should seek experienced, board-certified pediatric urologists or Centers of Excellence. Surgeons must ensure thorough patient/family education on lifelong implications.