Video: Dr. Sanders on Medical Malpractice

Los Angeles plastic surgeon Dr. George Sanders speaks about the common problems today with medical malpractice.

Do you realize that medical malpractice costs our country $55.6 billion dollars each year, with $45.6 billion being spent on tests and procedures done for no reason other than to avoid a malpractice suit ? Wow!! That’s a lot of moolah!! Most of that money is not spent by plastic surgeons, thank goodness! The $10 billion that’s left is spent defending doctors in malpractice suits. To understand plastic surgery malpractice suits better,  it’s very helpful to “look inside the courtroom,” as described in a recent article in the January 2014 edition of the Aesthetic Surgery Journal (Aesth Surg J. 2014;34:79-86).

The full title of the article is “A Look inside the Courtroom: An Analysis of 292 Cosmetic Surgery Medical Malpractice Cases.” As the title indicates, the article looks at 292 medical malpractice cases that were filed over the past 27 years in the United States. These cases all dealt with cosmetic breast surgery – augmentation, uplift, or reduction. The 7 most common alleged injuries that resulted in a lawsuit were:

• disfigurement
• need for a revision procedure
• scarring
• infection
• skin death, also known as necrosis
• asymmetry
• dissatisfaction with size

Why did patients file a lawsuit? In 89% of the lawsuits, negligence on the part of the doctor was claimed. Negligence means that the doctor did not have the appropriate knowledge or skill to perform the procedure, or that he/she departed from the accepted standard of care that most physicians would have followed. In 44% of the cases, the patient claimed that they were not informed before surgery of risks or alternatives to the procedure performed. Other reasons for filing a lawsuit were less common.

Of those cases that went all the way to a verdict, 58% were decided in favor of the doctor and 42% in favor of the patient. If the patient accused the doctor of fraudulently representing their qualifications or misrepresenting the procedure in an intentional manner (fraud), 92% of those cases yielded a verdict in favor of the patient. On the other hand, if lack of informed consent was alleged by the patient, there was 35% less chance of an outcome favoring the patient.

What conclusions can be drawn by plastic surgeons and by potential plastic surgery patients?

• Because the number of malpractice suits is about the same for breast augmentation and reduction, and the number of augmentation cases is about 5 times the number of reductions, the chance of being sued by a patient following a breast reduction is greater than following an augmentation. I was surprised by this since reduction patients generally are delighted with any result that results in less pain and looks reasonably good.

• If the patient has signed an informed consent document prior to surgery, and almost all do, it is then quite difficult for a patient to convince a jury that there was lack of adequate informed consent. Even if the doctor does not discuss complications with the patient prior to surgery, the signed document appears to be sufficient to prove that informed consent was obtained. As a patient, you should make sure that you carefully read over the document you sign and ask any questions since this is considered by the courts to be all you really need to understand to be considered as well-informed.

• An experienced plastic surgeon should make sure to discuss each of the items listed on the alleged injury list above with the patient. Patients should also make sure that they are aware of each of these possibilities.

• The doctor must be careful not to misrepresent their qualifications or what a particular procedure can be expected to deliver when speaking with a patient. Misrepresentation makes it more likely that a malpractice suit will be more successful.

Feel free to comment.

George Sanders, M.D.