Uncovering malpractice in appendectomies: a review of 234 cases.

Background: General surgery is a "high-risk specialty" with respect to medical malpractice rates, and appendicitis is one of the most common diagnoses encountered by practitioners. Our objectives were to detail issues affecting malpractice litigation regarding appendicitis and appendectomies, including outcomes, awards, alleged causes of malpractice, and other factors instrumental in determining legal responsibility and increasing patient safety.

Study Design: Publically available federal and state court records were examined for pertinent jury verdict and settlement reports. Information from 234 pertinent cases was collected, including alleged causes of malpractice and outcomes.

Results: Of the 234 cases included in this study, the most common factor noted was an alleged delay in diagnosis (67.1%), followed by intraoperative negligence (16.2%). Alleged deficits in informed consent, although only specifically cited as a cause of malpractice in 1.3% of cases, were found to be an important aspect of many cases. In total, 59.8% of cases were ruled in favor of the physician, 23.7% in favor of the plaintiff, and 5.5% reached a settlement. The average plaintiff award was US $794,152, and the average settlement award was US $1,434,286.

Conclusion: An important strategy to decrease liability in a physician's practice is prompt evaluation of an appendicitis patient. An integral part of this is efficient communication between physicians practicing a wide variety of specialties, especially including practitioners in emergency medicine and general surgery. Additionally, completing a thorough informed consent explaining all aspects of the procedure including the factors we outline will not only increase patient awareness of potential risks but also protect the physician in the face of litigation.