Medical malpractice litigations involving aortic dissection

Objectives: Medical malpractice litigation arises when a discrepancy exists between a patient's expectation of acceptable medical care and the care the patient receives. Aortic dissection is a frequently misdiagnosed and often-fatal condition. The purpose of this study was to characterize trends of medical malpractice litigations arising from aortic dissection, investigate the etiology, and analyze predictive factors regarding the verdict.

Methods: The Westlaw legal database was used to compile relevant litigations from 1994 to 2019 across the United States. Each litigation was screened individually for inclusion, and after inclusion, descriptive factors were compiled, including patient data, litigation data, verdict data, and clinical outcomes data. The Fisher exact test was used to evaluate the significance of association between parameters and verdict type.

Results: In total, 135 unique litigations met criteria for inclusion, with a defendant verdict in 57% (n = 77), plaintiff verdict in 20% (n = 27), and settlements in 23% (n = 31). Plaintiffs most commonly cited a failure to diagnose as their reason for litigation in 64% (n = 87). Patient mortality was associated with a lower average plaintiff award, $1,892,781 versus $5,944,983, and a lower average settlement, $1,230,923 versus $2,250,000, than their surviving counterparts. California, Illinois, and Pennsylvania had the most cases filed. An alleged failure to test, failure to refer, failure to consult, incidence of a stroke, and incidence of an autopsy diagnosis were significantly associated with defendant verdicts and a failure to diagnose was significantly associated with plaintiff verdicts (P < .05).

Conclusions: Plaintiffs frequently cited a failure to timely diagnose, order diagnostic tests, and interpret diagnostic tests as reasons for litigations. Defendant verdicts were common, suggesting judicially acceptable standards of care are commonly satisfied.