Pediatrics neurosurgical malpractice claims: a 43-year review of legal databases

Neurosurgery, particularly pediatric neurosurgery, is associated with high malpractice risks due to the complexity of procedures and potential for severe complications. However, comprehensive reviews of medical malpractice cases specifically involving pediatric neurosurgeons are scarce. This study aimed to analyze trends in malpractice litigation within the pediatric neurosurgical field in the United States.

A search was conducted of the LexisNexis and Westlaw legal databases for medical malpractice cases involving pediatric neurosurgeons from 1979 to 2022. Cases were included if they involved a pediatric neurosurgical condition, a patient younger than 21 years of age, and at least one defendant who was a pediatric neurosurgeon. Fourteen cases met the inclusion criteria and were analyzed for clinical conditions, allegations, outcomes, and other relevant factors.

Most cases originated from the southern United States, with spina bifida/tethered cord and subdural hematomas being the most cited conditions. Allegations predominantly focused on failure to diagnose or treat (57%, 8/14 cases) particularly in relation to hydrocephalus and spina bifida. Nine cases favored the defendant, 1 resulted in a plaintiff's verdict, and the outcome of 4 cases was unknown or a mixed verdict. Plaintiff age typically ranged from younger than 3 years to more than 13 years.

These findings highlight the prevalence of specific conditions such as spina bifida and hydrocephalus in malpractice cases involving pediatric neurosurgeons. While most cases favored the defendant, these conditions and the high acuity of pediatric neurosurgical care continue to present significant risks. Future research incorporating insurance provider data could offer further insights into malpractice trends in this field. This study provides a detailed overview of malpractice claims in pediatric neurosurgery, identifying key conditions and trends. Understanding these patterns is crucial for enhancing risk management and patient care in pediatric neurosurgery.