Skip to main content

Advertisement

SpringerLink
Log in

Cholecystectomy-related malpractice litigation: predictive factors of case outcome

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Complications following cholecystectomy may lead to malpractice litigation. Little research exists regarding cholecystectomy-related malpractice, the complications that lead to litigation, and the outcomes of such cases. This study is a retrospective analysis utilizing the legal database Verdictsearch (ALM Media Properties, LLC, New York, NY). Medical malpractice cases between July 2004 and November 2017 were identified using the search term “gallbladder.” Case information was recorded, including patient information, medical details, trial outcome, and resulting payments. Of 46 cases examined, 39 went to trial with a favorable plaintiff (patient) verdict in 43% (20/46) and a favorable physician verdict in 41% (19/46) of the cases. Only 7% (3/46) of the cases resulted in a settlement, with 4% (2/26) concluding in mixed verdicts or arbitration. The mean plaintiff victory payment was $723,844 ± $1,119,457, while the mean settlement payment was $1,350,000 ± $563,471. Intraoperative care was the most frequently litigated phase of care (67%, 31/46 cases). Problematic visualization of the surgical field was the most frequent intraoperative allegation (67.7%, 21/46 cases). Cases of problematic visualization often resulted in favorable plaintiff trial victory (66.7% vs. 19% in defendant victory). Only 9.5% of the problematic visualization cases settled. Bile duct injuries accounted for 43.5% of the injuries (plaintiff victory rate 60.0%; mean payment $736,434 ± $1,365,424). In cholecystectomy litigation, allegations of problematic intraoperative visualization are both the most common allegation and the most likely to end in physician loss. Bile duct injuries remain the most frequent patient injury leading to cholecystectomy litigation

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jena AB, Seabury S, Lakdawalla D, Chandra A (2011) Malpractice risk according to physician specialty. N Engl J Med 365(7):629–636

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Roy PG, Soonawalla ZF, Grant HW (2009) Medicolegal costs of bile duct injuries incurred during laparoscopic cholecystectomy. HPB 11(2):130–134

    Article  PubMed  PubMed Central  Google Scholar 

  3. Barnes D (2010) Gallbladder and biliary tract disease. Cleveland Clinic, Cleveland

    Book  Google Scholar 

  4. Alexander HC, Bartlett AS, Wells CI, Hannam JA, Moore MR, Poole GH et al (2018) Reporting of complications after laparoscopic cholecystectomy: a systematic review. HPB 20(9):786–794

    Article  PubMed  Google Scholar 

  5. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 165(1):9–14

    Article  CAS  Google Scholar 

  6. McLean TR (2006) Risk management observations from litigation involving laparoscopic cholecystectomy. Arch Surg 141(7):643–648

    Article  PubMed  Google Scholar 

  7. Kern KA (1997) Malpractice litigation involving laparoscopic cholecystectomy: cost, cause, and consequences. Arch Surg 132(4):392–398

    Article  CAS  PubMed  Google Scholar 

  8. Parmeggiani D, Cimmino G, Cerbone D, Avenia N, Ruggero R, Gubitosi A et al (2010) Biliary tract injuries during laparoscopic cholecystectomy: three case reports and literature review. Il Giornale di Chirurgia 31(1):16–19

    CAS  PubMed  Google Scholar 

  9. Hugh TB (2002) New strategies to prevent laparoscopic bile duct injury—surgeons can learn from pilots. Surgery 132(5):826–835

    Article  PubMed  Google Scholar 

  10. Physician Insurers Association of America (2000) Laparoscopic injury study. https://www.thepiaa.org/pdf_files/order_forms/2004_Non_Member_Publication_Order_Form.pdf. Accessed January 2005.

  11. Fellmer PT, Fellmer J, Jonas S (2011) Liability of surgeons with respect to injuries to the bile duct during laparoscopic cholecystectomy: analyses of malpractice litigations in the years 1996–2009. Der Chirurg Zeitschrift fur alle Gebiete der operativen Medizen 82(1):68–73

    Article  CAS  PubMed  Google Scholar 

  12. DePasse JM, Sargent R, Fantry AJ, Bokshan SL, Palumbo MA, Daniels AH (2017) Assessment of malpractice claims associated with acute compartment syndrome. JAAOS 25(6):e109–e113

    PubMed  Google Scholar 

  13. Daniels AH, Ruttiman R, Eltorai AE, DePasse JM, Brea BA, Palumbo MA (2017) Malpractice litigation following spine surgery. J Neurosurg Spine 27(4):470–475

    Article  PubMed  Google Scholar 

  14. Bokshan SL, Ruttiman R, Eltorai AE, DePasse JM, Daniels AH, Owens BD (2017) Factors associated with physician loss in anterior cruciate ligament reconstruction malpractice lawsuits. Orthop J Sports Med 5(11):2325967117738957

    Article  PubMed  PubMed Central  Google Scholar 

  15. Shah, K. N., Eltorai, A. E., Perera, S., Durand, W. M., Shantharam, G., Owens, B. D., et al. (2018). Medical Malpractice Litigation Following Arthroscopic Surgery. Arthroscopy: The Journal of Arthroscopic Related Surgery, 34(7):2236-2244

  16. Thiels CA, Choudhry AJ, Ray-Zack MD, Lindor RA, Bergquist JR, Habermann EB, Zielinski MD (2018) Medical malpractice lawsuits involving surgical residents. JAMA Surg 153(1):8–13

    Article  PubMed  Google Scholar 

  17. Abadin SS, Kaplan EL, Angelos P (2010) Malpractice litigation after thyroid surgery: the role of recurrent laryngeal nerve injuries, 1989–2009. Surgery 148(4):718–723

    Article  PubMed  Google Scholar 

  18. Flum DR et al (2003) Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. JAMA 289(13):1639–1644

    Article  PubMed  Google Scholar 

  19. Anandalwar SP, Scholer AJ, Ninan G, Oliver JB, Christian D, Eloy JA, Chokshi RJ (2017) Dissecting malpractice in pancreaticoduodenectomy cases. J Surg Res 212:48–53

    Article  PubMed  Google Scholar 

  20. Casey BE, Civello KC, Martin LF, O'leary JP (1999) The medical malpractice risk associated with bariatric surgery. Obes Surg 9(5):420–425

    Article  CAS  PubMed  Google Scholar 

  21. Mangieri CW, Hendren BP, Strode MA, Bandera BC, Faler BJ (2018) Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era. Surg Endosc 33(3):724–730

    Article  PubMed  Google Scholar 

  22. Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23(4):896–899

    Article  CAS  PubMed  Google Scholar 

  23. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992) Laparoscopic cholecystectomy: the new 'Gold Standard'? Arch Surg 127(8):917–923

    Article  CAS  PubMed  Google Scholar 

  24. Hamad MA, Nada AA, Abdel-Atty MY, Kawashti AS (2011) Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study. Surg Endosc 25(12):3747–3751

    Article  PubMed  Google Scholar 

  25. Pucher PH, Brunt LM, Davies N, Linsk A, Munshi A, Rodriguez HA et al (2018) Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis. Surg Endosc 32(5):2175–2183

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ankersmit M, van Dam DA, van Rijswijk AS, van den Heuvel B, Tuynman JB, Meijerink WJ (2017) Fluorescent imaging with indocyanine green during laparoscopic cholecystectomy in patients at increased risk of bile duct injury. Surg Innov 24(3):245–252

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gangemi A, Danilkowicz R, Elli FE, Bianco F, Masrur M, Giulianotti PC (2017) Could ICG-aided robotic cholecystectomy reduce the rate of open conversion reported with laparoscopic approach? A head to head comparison of the largest single institution studies. J Robot Surg 11(1):77–82

    Article  CAS  PubMed  Google Scholar 

  28. Pietrabissa A, Sbrana F, Morelli L, Badessi F, Pugliese L, Vinci A et al (2012) Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology. Arch Surg 147(8):709–714

    Article  PubMed  Google Scholar 

  29. Sharma S, Huang R, Hui S, Smith MC, Chung PJ, Schwartzman A, Sugiyama G (2018) The utilization of fluorescent cholangiography during robotic cholecystectomy at an inner-city academic medical center. J Robot Surg 12(3):481–485

    Article  PubMed  Google Scholar 

  30. Guloglu R, Dilege S, Aksoy M, Alimoglu O, Yavuz N, Mihmanli M, Gulmen M (2004) Major retroperitoneal vascular injuries during laparoscopic cholecystectomy and appendectomy. J Laparoendosc Adv Surg Tech 14(2):73–76

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Warren Alpert Medical School, Brown University, 34 Olive St, Box 9014, Providence, RI, USA

    Davis A. Hartnett, Adam E. M. Eltorai, Adena J. Osband, Shaan A. Ahmed & Alan H. Daniels

Authors
  1. Davis A. Hartnett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adam E. M. Eltorai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adena J. Osband
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shaan A. Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alan H. Daniels
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Davis A. Hartnett.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This study is conducted in compliance with the ethical standards. This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hartnett, D.A., Eltorai, A.E.M., Osband, A.J. et al. Cholecystectomy-related malpractice litigation: predictive factors of case outcome. Updates Surg 71, 463–469 (2019). https://doi.org/10.1007/s13304-019-00633-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-019-00633-4

Keywords

Search

Navigation