Objective
To examine the factors associated with iatrogenic ureteral injury litigation and outcomes.
Methods
The Westlaw legal database was queried for all iatrogenic ureteral injury cases. Variables
extracted included available clinical factors, method of settlement, and litigation
outcomes. Linear regression analysis was conducted to examine factors associated with
award amount.
Results
A total of 522 cases from 1961 to 2019 were included in the study. The most common
specialty named was gynecology (353/512, 68.9%), followed by urology (89/512, 17.4%).
The most common claim was intraoperative negligence (474/522 cases, 90.8%). Fifty
two cases were settled or arbitrated and 470 went to trial. Settlement or arbitration
was more likely in cases involving institution-only defendant (15.4% vs 7.3%, P< .01), academic institution (19.7% vs 7.1%, P < .01), and patient death (42.9% vs 10.7%; P < .001). Of cases that went to trial, the verdict favored the defendant in 339/470
cases (72.1%). The median award was $552,822.96 (interquartile range 187,007-1,063,603).
Duration of temporary drainage ($5050/day, P = .02), delayed repair (P = .03), claim of inadequate workup (P = .03), and claim of failure to supervise trainee (P < .001) were significantly associated with increasing award amount.
Conclusion
The majority of ureteral injury litigation ruled in favor of the defendant. However,
when awarded, the amount was substantial and correlated with drainage duration, delayed
repair, claim of inadequate workup, and failure to supervise trainee. These findings
highlight factors perceived to be associated with significant distress and reflect
trends in medicolegal decision-making.
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Article info
Publication history
Published online: September 08, 2020
Accepted:
August 19,
2020
Received:
April 15,
2020
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
