Litigation Patterns of Acute Compartment Syndrome: Distinctions Between Orthopaedic and Non-Orthopaedic Cases and...

Area of Science:

• Medical Malpractice Law
• Orthopaedic Surgery
• Trauma Surgery

Background:

• Acute compartment syndrome (ACS) is a critical condition leading to significant medical litigation across various surgical specialties.
• Understanding the differences in ACS-related lawsuits between orthopaedic surgeons and other medical practitioners is crucial for risk management.

Purpose of the Study:

• To compare the characteristics and outcomes of ACS-related litigation against orthopaedic surgeons versus surgeons in other specialties.
• To identify key factors contributing to malpractice claims in ACS cases.

Main Methods:

• A comprehensive search of the Westlaw database was conducted for ACS-related medical malpractice cases in the U.S. from 1980 to 2023.
• Cases involving jury verdicts or settlements concerning ACS of the spine and extremities were included, excluding abdominal ACS.
• Data analysis focused on defendant specialty, basis of litigation, and case outcomes.

Main Results:

• Of 358 eligible cases, 150 (42%) involved orthopaedic surgeons.
• Orthopaedic surgeons were more frequently named in cases related to fractures and improper cast/splint application (p < 0.001).
• Non-orthopaedic practitioners were more often involved in cases citing medication or fluid administration errors (p < 0.001).

Conclusions:

• ACS litigation carries substantial financial and patient outcome burdens.
• Documentation of compartment checks and intracompartmental pressure measurements may mitigate medicolegal risks.
• Prophylactic fasciotomies have not been a significant source of litigation.