Abstract
Introduction:
Medical malpractice and prostate cancer screening are important issues in the current landscape of health care. We identified factors contributing to litigation in the diagnosis of prostate cancer.
Methods:
We used the Westlaw® database to search for jury verdict reports using the term medical malpractice combined with prostate cancer with dates ranging from January 2000 to December 2013. Each case was examined for trial year, patient age, prostate specific antigen at alleged breach of duty and at diagnosis, defendant specialty, alleged cause of malpractice, whether there was metastasis, the outcome of cases that went to trial or were otherwise settled, and the plaintiff award.
Results:
The initial search produced 256 results, which was narrowed to 106 cases. Of these cases 64.1% went to trial, including 66.2% that were decided for the defendant. The mean out of court settlement was $945,000, significantly lower than the mean plaintiff verdict award of $2.1 million (p = 0.0009). Primary care physicians (74.1%) were the most commonly named defendants, followed by urologists (19.6%). The most common cause was failure to perform an initial prostate specific antigen test (26.8%), followed by failure to follow elevated prostate specific antigen (22.3%).
Conclusions:
Causes of malpractice revolved mostly around prostate specific antigen testing. Primary care physicians and urologists must continue to educate patients to minimize malpractice claims made in this setting. It will be important to follow data to see trends following recent guidelines.
References
- 1 : Health spending in the United States and the rest of the industrialized world. Health Aff Proj Hope2005; 24: 903. Google Scholar
- 2 : Malpractice risk according to physician specialty. N Engl J Med2011; 365: 629. Google Scholar
- 3 : Malpractice risks for urologists. Urology1998; 51: 183. Google Scholar
- 4 : Missed diagnoses by urologists resulting in malpractice payment. J Urol2007; 178: 2537. Link, Google Scholar
- 5 : Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med2012; 157: 120. Google Scholar
- 6 : Mortality results from a randomized prostate-cancer screening trial. N Engl J Med2009; 360: 1310. Google Scholar
- 7 : Randomised prostate cancer screening trial: 20 year follow-up. BMJ2011; 342: d1539. Google Scholar
- 8 : Screening and prostate-cancer mortality in a randomized European study. N Engl J Med2009; 360: 1320. Google Scholar
- 9 : Early detection of prostate cancer: AUA Guideline. J Urol2013; 190: 419. Link, Google Scholar
- 10 : Comparison of plaintiff and defendant expert witness qualification in malpractice litigation in neurological surgery. J Neurosurg2014; 120: 185. Google Scholar
- 11 : Esophageal perforation and rupture: a comprehensive medicolegal examination of 59 jury verdicts and settlements. J Gastrointest Surg2013; 17: 1732. Google Scholar
- 12 : Determination of legal responsibility in iatrogenic tracheal and laryngeal stenosis. Laryngoscope2013; 123: 1754. Google Scholar
- 13 : Analysis of lawsuits filed against emergency physicians for point-of-care emergency ultrasound examination performance and interpretation over a 20-year period. Am J Emerg Med2012; 30: 338. Google Scholar
- 14 : Managing incidental genomic findings: legal obligations of clinicians. Genet Med2013; 15: 624. Google Scholar
- 15 : The standard of care: legal history and definitions: the bad and good news. West J Emerg Med2011; 12: 109. Google Scholar
- 16 : Cancer statistics, 2013. CA Cancer J Clin2013; 63: 11. Google Scholar
- 17 : Health Law. St. Paul: West1997. Google Scholar
- 18 : Primary care physician PSA screening practices before and after the final U.S. Preventive Services Task Force recommendation. Urol Oncol2014; 32: 41.e23. Google Scholar
- 19 : Prostate-specific antigen testing: men’s responses to 2012 recommendation against screening. Am J Prev Med2013; 45: 182. Google Scholar
- 20 : Influencing factors leading to malpractice litigation in radical prostatectomy. J Urol2014; 191: 1770. Link, Google Scholar
