Characterization of Medical Malpractice Litigation After Rhinoplasty in the United States

Overview

Patients may sue after rhinoplasty when a complication occurs or the result is not what they wanted. The study set out to identify why patients brought malpractice claims and how those claims were decided. The Westlaw legal database was searched for all available court decisions relating to malpractice after rhinoplasty, and the authors recorded plaintiff gender, location, defendant specialty, allegation and case outcome.

Sections of note

• Review of a legal database; 23 cases identified between 1960 and 2018, across 12 US states.
• Seventy percent of plaintiffs were female.
• Otolaryngologists were cited in 11 cases and plastic surgeons in 12.
• All cases alleged negligence.
• Allegations included technical errors 69.6 percent, unsatisfactory outcomes 39.1 percent, inadequate follow up or aftercare 30.4 percent, informed consent problems 21.7 percent, unexpectedly extensive surgery 8.7 percent, improper medication administration 4.3 percent and failure to recognize symptoms 4.3 percent.
• Twenty of 23 adjudicated cases, 86.9 percent, were ruled in favour of the surgeon.
• The main contributing factor was poor aesthetic outcome or disfigurement, 60.7 percent.

What it means for a patient

• Appearance, not breathing or medical harm, was the dominant reason patients went to court.
• Nearly a third of cases involved complaints about follow up care rather than the operation itself.
• Only 23 cases were found over 58 years, because most disputes settle or never reach a published decision.
• The database covers decided cases only, so it says nothing about how often patients complain or settle.

Why this paper matters

Litigation records show which failures patients treat as unacceptable, which is different from what surgeons record as complications. This study identifies unmet aesthetic expectation as the driver. The authors' recommendations on consent and communication follow from the pattern rather than from tested evidence.

Terms

• Malpractice litigation: a lawsuit alleging that care fell below the accepted standard.
• Plaintiff: the person bringing the lawsuit.
• Negligence: failure to provide the standard of care a reasonable practitioner would give.
• Informed consent: the process of explaining risks and alternatives before a patient agrees.
• Adjudicated: decided by a court rather than settled privately.