Presentation Authors: Brandon S. Childs, MD*, Burlington, MA, Karissa Smith, Philadelphia , PA, Kathryn M. Kelley, Denver , CO, Peter L. Steinberg, MD, Boston , MA
Introduction: Kidney stones are one of the most litigated diagnoses in urologic practice. To better understand the cause for and outcomes of medical malpractice cases related to nephrolithiasis, we analyzed United States medical malpractice appeals court cases from 2001-18.
Methods: We searched Lexis Nexis for "kidney stone/nephrolithiasis" and "malpractice" from 2001-2018. Cases were excluded where nephrolithiasis was in the differential, but not the final diagnosis. Individual case data were compiled and analyzed with descriptive statistics, including involved parties, outcome of the initial case/appeal, alleged physician negligence, monetary awards granted, and size of awards.
Results: Our search yielded 45 cases, of which 33 met criteria for analysis. The patient/spouse was the plaintiff in 69% (23/33) of cases; the patient's estate was found to be the plaintiff in 30% (10/33). A urologist was a defendant in 67% (19/33) of included trials and non-urologic providers were named in 30% (10/33). The associated hospital was named in 64% (21/33) of all lawsuits. A total of 85% (28/33) of suits cited an error in treatment as the primary negligence. Table 1 displays the outcomes of initial cases and appeals. Ten percent of cases were reversed on appeal and the majority of cases were found in favor of the defendant initially and on appeal. Overall, the defendant prevailed in 63% (21/33) of cases. Four trials involved payment to a plaintiff and the average payout was $1,075,439 (range: $193,000 - $3,000,000).
Conclusions: The majority of nephrolithiasis malpractice suits involve a verdict in favor of the urologist, physician, or hospital, even after appeal. Errors in treatment are much more commonly litigated than errors in diagnosis. Although the prevalence of plaintiff payout was low, awards granted averaged over a million dollars per case.