Malpractice Analysis Uncovers Surgical Safety Concerns

It is something that no doctor wants to be involved in, but the risk is a big reality for doctors, especially surgeons: Claims of malpractice against patients.

An analysis of orthopedic malpractice claims was conducted at the University of Washington and published in The Journal of Bone & Joint Surgery last month. The researchers sought areas where things can go wrong during orthopedic surgery.

The authors studied 464 closed malpractice cases. Their analysis included review of the affected part of the patient's body, the type of care, the type of allegation, and the claim payout amount from medical liability insurance.

Several areas of concern about patient safety during surgery were revealed by the study. One-third of the malpractice claims alleged permanent disabling injuries, such as amputation, brain damage, and major nerve damage.

The anatomic location with the highest impact was the spine. Spinal injuries represented 28% of dollars paid out and 15% of claims, and 45% of spine claims involved death or severe permanent injury.

For hip and knee surgery, the most common claim was failure of implant positioning. Malpractice claims for fracture surgeries involved improper bone alignment, dislocations, failure to protect structures in the surgical field, infection, and treatment complications.

Of the 464 malpractice claims in the study, insurance paid out in 88 of the cases. The total payout for these claims was almost 18 million dollars.

In the conclusion of the study, the authors revealed risk areas to target to improve patient safety during orthopedic surgery.


Matsen FA, Stephens L, Jette JL, Warme WJ, Posner KL. Lessons regarding the safety of orthopaedic patient care: an analysis of four hundred and sixty-four closed malpractice claims. J Bone Joint Surg Am. 2013; 95(4): 201-208.