Medical malpractice and epidural hematomas: a retrospective analysis of 101 cases in the United States

Abstract

Background: Neurosurgeons face particularly high rates of litigation compared to physicians in other fields. Malpractice claims are commonly seen after mismanagement of life-threatening medical emergencies, such as epidural hematomas. Due to the lack of legal analysis pertaining to this condition, the aim of this study is to identify risk factors associated with litigation in cases relating to the diagnosis and treatment of epidural hematomas. Materials and Methods: Westlaw Edge, an online database, was used to analyze malpractice cases related to epidural hematomas between 1986 to 2022. Information regarding plaintiff demographics, defendant specialty, reason for litigation, trial outcomes, and payouts for verdicts and settlements were recorded. Comparative analysis between cases that returned a jury verdict in favor of the plaintiff versus defendant was completed. Results: A total of 101 cases were included in the analysis. Failure to diagnose was the most common reason for litigation (n = 64, 63.4%), followed by negligent care resulting in an epidural hematoma (n = 44, 43.6%). Spine surgery (n = 29, 28.7%), trauma (n = 28, 27.7%), and epidural injection/catheter/electrode placement (n = 21, 20.8%) were the primary causes of hematomas. Neurosurgeons (n = 18, 17.8%) and anesthesiologists (n = 17, 16.8%) were the two most common physician specialties cited as defendants. Most cases resulted in a jury verdict in favor of the defense (n = 54, 53.5%). For cases ending in plaintiff verdicts, the average payout was $3,621,590.45, while the average payment for settlements was $2,432,272.73. Conclusion: Failure to diagnose epidural hematomas is the most common reason for malpractice litigation, with neurosurgeons and anesthesiologists being the most common physician specialties to be named as defendants. More than half of all cases returned a jury verdict in favor of the defense and, on average, settlements proved to be more cost-effective than plaintiff verdicts.