Open AccessFESS Malpractice Risk Factors Identified Using Case‐Controls
Author(s) -
Sewell Ryan K.,
Roberson David W.,
Zappia John J.,
Troxel David,
Shah Rahul K.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a235
Subject(s) - medicine , malpractice , functional endoscopic sinus surgery , medical malpractice , endoscopic sinus surgery , identification (biology) , surgery , ethmoidectomy , general surgery , sinusitis , botany , political science , law , biology , maxillary sinus
Objective Complications related to functional endoscopic sinus surgery are well documented. These complications will, in some instances, lead to claims of medical malpractice. This study seeks to preoperatively identify both patient and procedural characteristics which are more likely to result in adverse events. This may then allow them to develop risk management strategies as they pertain to functional endoscopic sinus surgery. Method Case control study of The Doctors Company closed claims involving functional endoscopic sinus surgery between 2005‐2009. These were then compared with a control group of 196 survey responses sent by The Doctors Company in 2011 to insured otolaryngologists. Results A total of 17 claims were closed from 2005‐2009. There was no significant age difference in the claims group and controls. Age greater than 60 inferred a 2.8‐fold increase in risk of a closed claim ( P =. 09). The lack of polyps was associated with an increased risk of a claim ( P =. 04). All claims involved surgery that included at least an ethmoidectomy. The use of powered instrumentation was not statistically significant. Revision surgery was associated with a 13‐fold increase in risk of a claim ( P =. 05). Conclusion The present article illustrates the utility of a case control method to identify scenarios that are more likely to result in malpractice claims. Identification of risk factors preoperatively has the potential to help avoid complications and, thus, lawsuits. This methodology may be useful when examining other surgical procedures as well.