From Operating Room to Courtroom: Analyzing Malpractice Trajectories in Cranial Neurosurgery

Area of Science:

• Neurosurgery
• Medical Malpractice Law
• Health Outcomes Research

Background:

• Neurosurgeons frequently face malpractice claims during their careers.
• Understanding national malpractice trends is crucial for informed practice and coverage needs.

Purpose of the Study:

• To assess national malpractice trends in cranial neurosurgery.
• To inform neurosurgeons about outcomes, trends, and mitigation strategies for lawsuits.

Main Methods:

• Analysis of medical malpractice cases for open cranial surgery from 1987-2023 using Westlaw Edge and LexisNexis.
• Extracted data included verdict dates, outcomes, injuries, and financial awards/settlements.

Main Results:

• 252 open cranial surgery malpractice cases were identified; median settlement $950,000, average plaintiff award $2,750,000.
• Award values increased significantly with time after inflation (P=.01), while defendant win rates remained stable (P=.43).
• Common claims involved tumor, vascular, infection, and trauma subspecialties, with perioperative complications and delayed treatment/diagnosis as primary litigation drivers.

Conclusions:

• While neurosurgeon win rates in malpractice cases are stable, award amounts have risen over 37 years.
• Perioperative complications and delayed treatment/diagnosis are significant factors contributing to malpractice claims.