Critical Analysis of Pediatric Orthopaedic Surgery Medical Malpractice Litigation: A Nationwide Retrospective Review.

Abstract

The primary aim of this study was to identify and characterize medical malpractice lawsuits pertaining to pediatric orthopaedic surgery. The Westlaw research database was queried for all jury verdicts and settlements pertaining to pediatric orthopaedic medical malpractice from 1980 to 2024. Cases were only included if the primary basis of litigation rested on a malpractice claim related to pediatric orthopaedic surgery and were levied against an orthopaedic surgeon. Data collected included date and state of case filing, patient (plaintiff) and surgeon (defendant) demographics, jury verdict, monetary awards, alleged negligence, and patient complications. Of 5,031 cases screened for inclusion, a total of 100 cases met the inclusion and exclusion criteria and were subsequently included in the final analysis. Plaintiff favorable outcomes were more commonly seen than a defendant verdict (56% vs. 44%). Patients most commonly presented for fracture management (62%), and most commonly underwent casting (30%). Alleged failure to diagnose was the most frequent basis of litigation (30%) and was predictive of a plaintiff outcome. The most frequent complication was the presence of permanent deformity (22%). A pediatric orthopaedic surgeon was the primary defendant in 59% of cases and was more commonly named following closed reduction and percutaneous pinning. Adult orthopaedic surgeons (41%) were more commonly named following fracture casting. The majority of medical malpractice cases in pediatric orthopaedic surgery result in plaintiff-favorable outcomes. Pediatric orthopaedic medical malpractice cases most often arise in the setting of fracture care and allegations of missed diagnoses. Patients pursuing litigation most frequently sustain permanent deformity as a result of the alleged negligence. Both pediatric and adult orthopaedic surgeons primarily face litigation following call-related fracture cases.