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Medical Malpractice and Bronchoscopy

Why Do Physicians Face Litigation?

Younis, Moustafa MBBS*; Sohail, Anees MBBS; Choudhry, Asad J. MBBS; Choudhry, Amad J. MBBS§; Abd-Rabu, Rami MBBS; Al-Shyoukh, Ahmad MD*; Wallen, Jason M. MD

doi: 10.1097/CPM.0000000000000340
Topics in Pulmonary Medicine

Despite bronchoscopy’s minimally invasive approach, it is not without errors and complications. When such errors do occur, patients may seek legal redress. The aim of the study was to describe the setting, contributing characteristics, and outcomes of litigation targeting bronchoscopic procedures. Westlaw (Thompson Reuters), an online legal research data set, was queried for all medical malpractice cases reported in the United States from 1983 to 2018 wherein bronchoscopy was performed. A total of 87 cases were included. Pulmonology was the most common specialty named in the cases (n=42, 48%). The most common alleged reason for litigation was procedural complication (n=25, 29%), followed by failure to diagnose (n=24, 28%) and failure to treat (n=16, 18%). A total of 49 cases (56%) were decided in favor of the defendant physician, and a settlement was reached before the trial verdict in 20 cases (23%). A verdict delivered in favor of the plaintiff occurred in 18 cases (21%). The median (interquartile range) plaintiff award and settlement payouts were $1,729,560 ($497,088 to $3,895,337) and $648,000 ($184,961 to $2,874,875), respectively. Failure to obtain complete informed consent was the only case characteristic that was significantly associated with an increased risk of payout (odds ratio: 6.67, 95% confidence interval: 1.1-84, P=0.04). Despite bronchoscopy’s utility in identifying numerous pulmonary pathologies, bronchoscopy-related complications were found to be the leading cause of litigation. Identifying and addressing errors with care and proper consent may reduce the number of malpractice claims related to bronchoscopy.

Level of Evidence: Level III.

*Department of Medicine, University of Missouri-Kansas City, Kansas City, MO

Department of Medicine, University of Lahore, Lahore, Pakistan

Department of Thoracic Surgery, SUNY Upstate University Hospital, Syracuse, NY

§Department of Medicine, Capital Health Regional Medical Center, Trenton, NJ

Department of Thoracic Surgery, Mayo Clinic, Rochester, MN

Presented in part at the American Thoracic Society 2019 Conference, May 22-27, 2019, in Dallas, TX.

M.Y., Asad J.C., A.S., R.A., and Amad J.C.: study design, data generation, analysis, and interpretation. M.Y., Asad J.C., J.W., and Amad J.C.: manuscript writing, and editing.

This study was exempted by the institutional review board, as the data were obtained from publicly available court records, and informed consent was not required.

Disclosure: The authors declare that they have no conflicts of interest.

Address correspondence to: Moustafa Younis, MBBS, Department of Internal Medicine, University of Missouri-Kansas City, 2411 Holmes St, Kansas City, MO 64108. E-mail:

Online date: November 25, 2019

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