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Plastic Surgery Legal Claims Review: What are we Getting Sued for Now & Can we Prevent it?

Cain Linville, M.D. Karol A. Gutowski, M.D.
The Ohio State University
2014-03-15

Presenter: Cain Linville, MD

Affidavit:
Write-up

Director Name: Greg Pearson, M.D.

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

"Closed claims" medical liability studies have been done for other specialties, but not for plastic surgery.

Methods:
Data were obtained from a single medical liability insurance company that covers over 1500 plastic surgeons (20-25% of plastic surgeons), 14% of which had a claim in 2011. A closed claims review of 2011 cases and a standardized review of all cases from 2000-2010 was done.

Results:
The severity of claims increased by 4% per year ($70,000 in 2001 to $101,000 in 2011). Over this same time, claims per plastic surgeon decreased (13% in 2001 to 8% in 2011), as they did for all physicians (39% to 14%). On average, plastic surgeons spend 15% of their career involved with a claim, while less than 5% of claims result in indemnity payments. Most common legal complaints are: dissatisfaction with results (29%), scar deformity (21%), infection (14%), and emotional distress (14%). The most common plastic surgery procedures identified are breast augmentation and abdominoplasty. Patient-related behavior comprised 48% of risk management issues, of which 67% sought other providers, 21% were non-compliant with treatment, and 12% were non-compliant with follow-up.

Discussion:
Most claims do not result in indemnity payments. Frequent claims are due to patient dissatisfaction with the following contributions: unrealistic expectations, unanticipated complications, patient behaviors. Since patient-physician communication contributed to 29% of claims, improved communication may reduce legal risk. Several strategies are identified to guide surgeons.

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