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J Gastrointest Surg. 2017 Jan;21(1):146-154. doi: 10.1007/s11605-016-3273-1. Epub 2016 Oct 11.

Medical Malpractice in Bariatric Surgery: a Review of 140 Medicolegal Claims.

Author information

1
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
2
Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
3
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA.
4
Department of Surgery, Mayo Clinic, Rochester, MN, USA. zielinski.martin@mayo.edu.
5
Division of Trauma, Critical Care, and General Surgery, St. Mary's Hospital, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. zielinski.martin@mayo.edu.

Abstract

OBJECTIVE:

Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery.

METHODS:

We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial.

RESULTS:

The search criteria yielded 298 case briefs, of which 140 met inclusion criteria. Thirty-two percent (n = 49) of cases involved male plaintiffs (patients). Mean patient age with standard deviation (SD) was 43 (10) years. The most common procedure litigated was the Roux-en-Y gastric bypass (76 %, n = 107). Overall, the most common alleged reason for a malpractice claim was delay in diagnosis or management of a complication in the postoperative period (n = 66, 47 %), the most common of which was an anastomotic leak (45 %, n = 34). Death was reported in 74 (52 %) cases. Fifty-seven cases (47 %) were decided in favor of the plaintiff (patient), with a median award payout of $1,090,000 (interquartile range [IQR] $412,500 to $2,550,000).

CONCLUSION:

Delay in diagnosing or managing complications in the postoperative setting, most commonly an anastomotic leak, accounted for the majority of malpractice claims. Measures taken to identify and address anastomotic leaks and other complications early in the postoperative period could potentially reduce the amount of filed malpractice claims related to bariatric surgery.

LEVEL OF EVIDENCE:

III.

KEYWORDS:

Bariatric surgery; Litigation; Medical malpractice; Westlaw

PMID:
27730397
DOI:
10.1007/s11605-016-3273-1
[Indexed for MEDLINE]

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