101. Medical Malpractice and Pediatric Hydrocephalus

Authors: Ishan S Naidu

Hydrocephalus contributes to significant morbidity, mortality, and healthcare costs in the pediatric population. The aim of this study is to identify demographics, reasons for litigation, and complications reported in pediatric hydrocephalus cases to increase providers’ awareness of factors associated with malpractice litigation.Methods: We queried litigation cases mentioning hydrocephalus in Westlaw legal database, including only cases pertaining to hydrocephalus management of neonates. Variables extracted included: plaintiff and defendant demographics, litigation category, plaintiff medical complaints, and trial outcome. We compared these characteristics between cases involving ventriculoperitoneal (VP) shunts and non-surgical interventions.
211 cases were identified and 12 met the inclusion criteria, 4 of which were VP shunt cases. Failure to diagnose (56%) was the most common type of malpractice claim. Individual specialties that most often required defense due to malpractice claims were Pediatrics (25%) and OBGYN (25%). Developmental delay (75%), seizure (75%), hemorrhage (50%), and meningitis (50%) were the most common plaintiff complaint for shunt cases, while developmental delay (50%), motor weakness (38%), paraplegia (25%), and disequilibrium (25%) were the most common for non-surgical cases. For shunt cases, 75% were plaintiff verdicts and 25% were settlements, with a median payout of $2,112,437. For non-surgical cases, 63% were settlements and 37% were defendant verdicts, with a median payout of $112,500.
Over one-half of the cases resulted in a settlement with failure to diagnose cited as the most common reason for litigation. Settlements resulted in a lower median payout than verdicts in favor of the plaintiff. Developmental delay was the most common plaintiff complaint for both shunt and non-surgical groups. These findings may inform providers on active measures to reduce unfavorable legal outcomes, such as increased focus on diagnostic accuracy, greater discussion on risks such as developmental delay during the informed consent process, and preemptive settlement discussions before trial.