There has always been a perception that trauma patients sue more often than other patients, and that trauma surgeons get sued more often than surgeons who do not provide trauma care. In several surveys polling surgical residents, this perceived malpractice risk is an impediment to considering a trauma practice. It is also frequently cited as a reason why established general surgeons do not want to engage in trauma care.
It is difficult to objectively study this area. Data sources are few and far between, and it is often difficult to get denominator information to determine the true incidence of lawsuits against trauma surgeons.
The University of Texas at San Antonio performed a nice study looking at their experience over a 12 year period. They compared the number of malpractice actions brought by patients who were undergoing an elective general surgical procedure, patients who underwent urgent or emergent general surgical procedures, and those who were classified as trauma patients.
They found that there were only 21 lawsuits served over the 12 year period, during which over 62,000 operations were performed. Seven were dismissed, 3 were granted summary judgments in favor of the physicians, and one went to trial and was decided in favor of the surgeon. Only half (10) were decided in favor of the patient. All were settled, with a total of $4.7 million in payouts. Legal defense costs were $1.3 million.
The ratios of lawsuits to operations performed were 3.0/100,000 for elective, 2.3/100,000 for urgent/emergent, and 3.1/100,000 for trauma. Given the total number of trauma patients evaluated, the ratio was 0.34 lawsuits per 100,000 trauma patients per year.
The bottom line: Health care is a complicated process, and there are bound to be a few adverse outcomes. The majority of these occur due to reasons that we do not yet fully understand. Lawsuits are rare, and as long as the physicians adhere to the standard of care, they frequently prevail. The idea that trauma surgeons get sued more frequently or more successfully than our non-trauma surgical colleagues is a fallacy that needs to finally be laid to rest.
Related post: Do trauma surgeons really get sued more often? Part one
Reference: Stewart et al. Trauma Surgery Malpractice Risk: Perception vs Reality. Annals of Surgery 241(6):969, 2005.