Medical Malpractice Litigations Involving Infant Craniosynostosis and Deformational Plagiocephaly in the United States

Abstract

Objective

To identify characteristics of malpractice litigations involving skull deformity in infants (craniosynostosis and deformational plagiocephaly).

Design

Retrospective review of all lawsuits with jury verdicts or settlements involving infant skull deformity as the primary diagnosis using the Westlaw Legal Database.

Setting

United States.

Patients, Participants

Plaintiffs with skull deformity as the primary diagnosis.

Main Outcome Measures

Litigation outcome and indemnity payment amount.

Results

From 1990 to 2019, 9 cases involving infant skull deformity met our inclusion/exclusion criteria. Among these cases, 8 (88.9%) cases resulted in indemnity payments to plaintiffs, totaling $30,430,000. Failure to diagnose (n = 4, 44.4%) and surgical negligence (n = 3, 33.3%) were the most common reasons for litigations.

Conclusions

There were a small number of malpractice lawsuits involving infant skull deformity over three decades. When cases go to court, physicians and hospitals have a high likelihood of judgment against them, frequently resulting in high indemnity payments.

Keywords

craniosynostosis deformational plagiocephaly infant skull deformity malpractice medicolegal

Get full access to this article

View all access options for this article.

References

Jena

Seabury

Lakdawalla

Chandra

. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629–636. doi:10.1056/NEJMsa1012370

Bal

. An introduction to medical malpractice in the United States. Clin Orthop. 2009;467(2):339–347. doi:10.1007/s11999-008-0636-2

Sasor

Chung

. Litigation in hand surgery: A 30-year review. Plast Reconstr Surg. 2020;146(4):430e. doi:10.1097/PRS.0000000000007157

Boyd

Moon

Martin

Mastrogiovanni

. Plastic surgery and the malpractice industry. Plast Reconstr Surg. 2021;147(1):239–247. doi:10.1097/PRS.0000000000007497

Gómez-Durán

Vizcaíno-Rakosnik

Martin-Fumadó

Klamburg

Padrós-Selma

Arimany-Manso

. Physicians as second victims after a malpractice claim: An important issue in need of attention. J Healthc Qual Res. 2018;33(5):284–289. doi:10.1016/j.jhqr.2018.06.002

Studdert

Mello

Sage

, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA. 2005;293(21):2609–2617. doi:10.1001/jama.293.21.2609

Mello

Chandra

Gawande

Studdert

. National costs of the medical liability system. Health Aff Proj Hope. 2010;29(9):1569–1577. doi:10.1377/hlthaff.2009.0807

Rich

Shelton

Glick

. Litigation involving pediatric surgical conditions. J Pediatr Surg. 2020;55(4):602–608. doi:10.1016/j.jpedsurg.2019.08.047

Svider

Eloy

Folbe

Carron

Zuliani

Shkoukani

. Craniofacial surgery and adverse outcomes: An inquiry into medical negligence. Ann Otol Rhinol Laryngol. 2015;124(7):515–522. doi:10.1177/0003489414567937

10.

Guardado

JR.

Medical Professional Liability Insurance Indemnity Payments, Expenses and Claim Disposition, 2006-2015. :9 .

11.

Overview of craniosynostosis - UpToDate. Accessed July 28, 2022. https://www-uptodate-com.revproxy.brown.edu/contents/overview-of-craniosynostosis?search=craniosynostosis%20diagnosis&source=search_result&selectedTitle=1∼64&usage_type=default&display_rank=1#H16

12.

Justin

Brietzke

SE.

Cleft lip and cleft palate surgery: Malpractice litigation outcomes. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc. 2017;54(1):75–79. doi:10.1597/15-285

13.

Gong JH, Kim DD, Mehrzad R. Medical malpractice litigations after hair restoration surgery in the United States. J Plast Reconstr Aesthet Surg. Published online June 28, 2022;75(8):2831–2870. doi:10.1016/j.bjps.2022.06.097

14.

Stedman’s | Medical. Accessed July 28, 2022. https://stedmansonline.com/public/Learnmore.aspx?resourceID=Medical

15.

Mabes

Chishom

Moraczewski

Dymanus

Linder

. Increasing incidence of craniosynostosis in the United States: Is folic acid supplementation responsible? Plast Reconstr Surg Glob Open. 2019;7(8 Suppl):40–41. doi:10.1097/01.GOX.0000584424.74207.04

16.

Cai

Sunshine

Boas

Kumar

. Evaluating the effects of enhanced recovery pathways in craniosynostosis: National trends in hospitalization charges and length of stay in craniosynostosis surgery. Ann Plast Surg. 2021;87(1 s):S60. doi:10.1097/SAP.0000000000002808

17.

CDC. Facts about Craniosynostosis | CDC. Centers for Disease Control and Prevention. Published December 4, 2019. Accessed July 27, 2022. https://www.cdc.gov/ncbddd/birthdefects/craniosynostosis.html

18.

Johnson

Wilkie

AOM

. Craniosynostosis. Eur J Hum Genet. 2011;19(4):369–376. doi:10.1038/ejhg.2010.235

19.

Masand

. Sagittal synostosis. BMJ Case Rep. 2010;2010:bcr0520103026. doi:10.1136/bcr.05.2010.3026

20.

Kajdic

Spazzapan

Velnar

. Craniosynostosis - recognition, clinical characteristics, and treatment. Bosn J Basic Med Sci. 2018;18(2):110–116. doi:10.17305/bjbms.2017.2083

21.

Aarnivala

Vuollo

Harila

Heikkinen

Pirttiniemi

Valkama

. Preventing deformational plagiocephaly through parent guidance: A randomized, controlled trial. Eur J Pediatr. 2015;174(9):1197–1208. doi:10.1007/s00431-015-2520-x

22.

Flannery

Tamber

Mazzola

, et al. Congress of neurological surgeons systematic review and evidence-based guidelines for the management of patients with positional plagiocephaly: Executive summary. Neurosurgery. 2016;79(5):623–624. doi:10.1227/NEU.0000000000001426

23.

Laughlin

Luerssen

Dias

, the Committee on Practice and Ambulatory Medicine S on NS. Prevention and management of positional skull deformities in infants. Pediatrics. 2011;128(6):1236–1241. doi:10.1542/peds.2011-2220

24.

Mathijssen

IMJ

. Guideline for care of patients with the diagnoses of craniosynostosis: Working group on craniosynostosis. J Craniofac Surg. 2015;26(6):1735–1807. doi:10.1097/SCS.0000000000002016

25.

Ross

Newman

. The role of apology laws in medical malpractice. J Am Acad Psychiatry Law. 2021;49(3):406–414. doi:10.29158/JAAPL.200107-20

26.

Kaldjian

Jones

Forman-Hoffman

Levi

Rosenthal

. Disclosing medical errors to patients: Attitudes and practices of physicians and trainees. J Gen Intern Med. 2007;22(7):988–996. doi:10.1007/s11606-007-0227-z

27.

LeCraw

Montanera

Jackson

Keys

Hetzler

Mroz

. Changes in liability claims, costs, and resolution times following the introduction of a communication-and-resolution program in Tennessee. J Patient Saf Risk Manag. 2018;23(1):13–18. doi:10.1177/1356262217751808