Malpractice in gynecologic cytology: a need for expert witness guidelines

The malpractice claims activity in anatomic pathology has sharply increased in recent years. On a relative and absolute basis, a leading area of increase for claims is cervicovaginal (Pap smear) cytology. As never before, pathologists are faced with the threat of litigation and acting as defendants in medical-legal actions. Defending claims of malpractice in Pap smear litigation can be difficult. The expert witness for the plaintiff often performs a selective retrospective review of the Pap smear of the plaintiff, compared with the screening examination performed by the defendant. In addition, it is unclear whether atypical or dysplastic cells are within the standard of practice and should be discovered by the Pap smear screener. A proposal for a forum to develop guidelines for expert witness testimony in Pap smear cytology is discussed.