MEDICOLEGAL ANALYSIS OF ERRORS IN DIAGNOSIS AND TREATMENT OF SURGICALENDOCRINE DISEASE

Background. The medicolegal impact of adverse events in surgical endoc rine disease has not been described previously. This study was underta ken to determine the causes, costs, and outcomes Of endocrine malpract ice litigation. Methods. Jury verdict reports from the U.S. civil cour t system from 1985 through 1991 were reviewed. Sixty-two malpractice c ases were identified from 21 states. Results. The 62 cases were classi fied into three categories, totaling 63 adverse events: (1) complicati ons (n = 34, 54%) from thyroid (n = 32, 57%) or parathyroid (n = 2, 3% ) surgery; (2) delayed diagnosis (n = 22, 35%) of thyroid cancer (n = 11, 18%), adrenal tumors (n = 9, 14%), and hyperparathyroidism (n = 2, 3%); and (3) medical morbidity (n = 7, 11 %) from radioactive iodine (n = 5, 8%) or from propylthiouracil (n = 2, 3%). Surgical injuries, m ostly recurrent nerve injuries by general surgeons, accounted for the greatest number of cases and the highest cost of litigation. Conclusio ns. Medical malpractice involving endocrine disease results in expensi ve litigation, a result of serious harm. Technical misadventures accou nt for most cases, followed closely by delays in diagnosis. These data may aid design of risk prevention strategies in endocrine disease.