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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Malpractice and Litigation in Elective Carpal Tunnel Release Surgery
Nishant Ganesh Kumar, BS1; Nicholas Hricz, BS2; Brian C. Drolet, MD1
1Vanderbilt University Medical Center, Nashville, TN;  2University of Maryland, College Park, Baltimore, MD

Introduction: Although carpal tunnel release (CTR) has routinely excellent outcomes, complications from this procedure can be devastating and litigation is a likely outcome in some of these cases. The purpose of this study was to investigate malpractice suits following carpal tunnel release and to examine factors related to legal outcomes.

Methods: The WestLaw legal database was searched for malpractice litigation related to CTR. Only cases directly related to injury after elective CTR were included in this study. Jury verdicts and settlement reports were reviewed to determine geographic and yearly trends, case liability, plaintiff and defendant demographics, defendant training, alleged injury and cause, case outcomes, awards and settlements.

Results: The search identified 92 cases between 1986 and 2016; only 7 cases were related to endoscopic CTR. Cases were distributed with greater frequency in more populous states. Plaintiffs were predominantly female (71%) with a mean age of 45, which is consistent with reported epidemiology. Orthopaedic surgeons were the most common defendants (73%); only 27% of all defendants were fellowship-trained in hand surgery. The majority of cases were found in favor of the defendant (66%). Monetary awards were granted in only 25 cases (27%). Plaintiff awards averaged $305,923 (range = $12,000 - 1,338,147). Liability was most commonly attributed to surgeon negligence (80%) with damages suffered following median nerve injury (60%).

Conclusion: Although median nerve injury is a known (and rare) complication of CTR, it is the most common reason for litigation against surgeons. Successful plaintiffs were able to demonstrate liability resulting from surgeon negligence. Plaintiff damages following median nerve injury are significant, and the resulting awards from jury verdicts are substantial. Defendants in CTR litigation most commonly did not have hand surgery fellowship training.

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