Neurosurgical Malpractice Litigation: A Systematic Review and Meta-Analysis

Area of Science:

• Medical Malpractice
• Neurosurgery Litigation
• Healthcare Risk Management

Background:

• Neurosurgery is recognized as a high-risk medical specialty with a significant incidence of malpractice claims.
• Understanding the factors contributing to neurosurgical malpractice is crucial for improving patient safety and reducing litigation.

Purpose of the Study:

• To systematically review and analyze the factors associated with neurosurgical malpractice claims and litigation in the United States.
• To report the outcomes of these malpractice claims and identify trends in neurosurgical practice.

Main Methods:

• A systematic literature review was conducted following PRISMA guidelines.
• Searches were performed across major databases including Medline, Embase, Cochrane, PubMed, and Google Scholar.
• Studies focusing on US-based neurosurgical malpractice claims and outcomes were included.

Main Results:

• 15 studies reviewed over 7890 malpractice claims involving US neurosurgeons (2002-2023).
• Spine surgeries accounted for a larger proportion of claims (1926) compared to brain surgeries (474).
• Top claims included intraprocedural errors (37.4%), delayed diagnoses (32.1%), and failure to treat (28.8%). Defendants were favored in 44.3% of claims.

Conclusions:

• Neurosurgery faces a high rate of malpractice claims, with spinal procedures being more frequently litigated.
• Cranial malpractice claims are linked to higher compensation, and spinal cord injuries are key predictors of litigation.
• Liability also arises from nonsurgical treatments, indicating a need for comprehensive risk management in neurosurgical practice.