Malpractice litigation after thyroid surgery: What factors favor surgeons?

Background: Litigation impacts physicians financially, reputationally, and professionally. Although thyroid surgery has favorable patient outcomes, litigation persists. We aimed to characterize malpractice claims after thyroidectomy and investigate which factors favor physicians.

Methods: We queried the Westlaw legal database using the terms "thyroidectomy" and "medical malpractice" to identify malpractice cases brought against surgeons from 1949 to 2022. We collected and analyzed demographic; clinical; surgical; and legal data, including year, cause for initiating litigation, verdict, state where the lawsuit was brought, and the state's tort reform status.

Results: Of the 68 cases included, medical negligence was the most common cause of action, followed by failure to provide adequate informed consent. The most common inciting surgical event was recurrent laryngeal nerve injury (n = 34, 50%). Surgeons prevailed more often overall (n = 53, 77.9%) and in 11 (91.7%) of the 12 cases treated at academic institutions. The 3 endocrine surgery fellowship-trained surgeons all prevailed in their cases. Of the 15 cases in which patients prevailed, 12 (80%) of which were decided by a jury, the median damages awarded were $569,668 (interquartile range $341,146-$2,594,050). In the 53 cases won by surgeons, 26 were jury decisions (49.1%). Surgeons prevailed in 87.5% of cases brought in the 24 states with tort reform and in 72.7% in the 44 states without tort reform.

Conclusion: Non-jury cases and operations done at academic institutions appear to favor decisions for the defendant. Although not statistically significant, all endocrine surgery fellowship-trained defendants won. Where tort reforms are in place, surgeons tend to prevail.