Medical malpractice litigation involving otolaryngology residents and fellows: A case-based 30-year review

BACKGROUND Errors, misdiagnoses, and complications can occur while trainees are involved in patient care. Analysis of such events could reveal areas for improvement by residency and fellowship programs.AIM To examine lawsuits tried at the state and federal level involving otolaryngology trainees.METHODS The LexisNexis database, an online legal research database containing state and federal case records from across the United States, was retrospectively reviewed for malpractice cases involving otolaryngology residents or fellows from January 1, 1990 to December 31, 2020. Case data collected: Plaintiff/trainee/defendant characteristics, allegations, medical outcomes, and legal outcomes.RESULTS Over the study period, 20 malpractice lawsuits involving otolaryngology trainees were identified. Plaintiffs raised numerous allegations including procedural error（n = 12, 25.5%）,incorrect diagnosis and/or treatment（n = 8, 17.0%）, and lack of knowledge of trainee involvement（n = 6, 12.8%）. Nine cases（45%） had verdicts in favor of the plaintiff, whereas 5 cases（25%） had verdicts in favor of the defense. Six cases（30%） ended in a settlement. Awards to plaintiffs were heterogenous, with a median of $617,500（range $32K-17M） for settled cases and verdicts favoring plaintiffs.CONCLUSION The findings enclosed herein represent the first published analysis of trainee involvement in otolaryngology malpractice cases held at the state/federal level. Otolaryngology trainees can be involved in lawsuits for both procedural and nonprocedural events. This study highlights the importance of education specifically in the domains of procedural errors, informed consent, proper diagnosis/management, and clear communication within patient care teams. Training programs should incorporate these study findings into effective simulation courses and didactic sessions.Educating trainees about common pitfalls holds the promise of decreasing healthcare systems costs, reducing trainee burnout, and, most importantly, benefiting patients.