Thiels CA, et al. – This study aimed to better understand lawsuits targeting surgical trainees to prevent future litigation. Researchers here reviewed malpractice cases involving surgical residents and realized the importance of perioperative management, particularly among junior residents, and the importance of appropriate supervision by attending physicians as targets for education on litigation prevention.

Methods

• A retrospective review of Westlaw, an online legal research database containing legal records from across the United States, was performed to assess malpractice cases involving surgical interns, residents, or fellows from January 1, 2005, to January 1, 2015.
• Researchers excluded infant–related obstetric and ophthalmologic procedures.
• Using descriptive statistics, they analyzed data regarding patient demographics, case characteristics, and outcomes.

Results

• During a 10–year period, researchers identified 87 malpractice cases involving surgical trainees.
• Data indicated that a total of 50 patients were female (57%), and 79 were 18 years of age or older (91%), with a median patient age of 44.5 years (interquartile range, 45–56 years).
• Death or permanent disability was observed in a total of 67 cases (77%).
• They noticed involvement of elective surgery in most cases (61 [70%]) and a junior resident was named as a defendant (24 of 35 [69%]).
• More frequently cases questioned the perioperative medical knowledge, decision making errors, and injuries (53 [61%]: preoperative, 19 of 53 [36%]) and postoperative, 34 of 53 [64%]) than intraoperative errors and injuries (43 [49%]).
• Primary involvement of junior residents was observed with lawsuits related to medical decision making (21 of 24 [87%]).
• In 10 cases (12%), residents’ failure to evaluate the patient was cited and in 48 cases (55%), lack of direct supervision by attending physicians was cited .
• Observations revealed a total of 42 cases (48%) that led to a jury verdict or settlement in favor of the plaintiff, with a median payout of $900 000 (range, $1852 to $32 million).