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065. Medical Malpractice and Pediatric Epilepsy: An Analysis of 44 Cases

Authors: Nathan A. Shlobin

Introduction:
Pediatric neurosurgeons face a high risk of litigation. Surgical management of epilepsy in pediatric patients is particularly challenging, potentially subjecting pediatric neurosurgeons to medical malpractice. In this study, we aimed to analyze malpractice claims related to children with epilepsy.Methods: The Westlaw and LexisNexis Search databases were cross-referenced to compile a comprehensive list of malpractice litigation related to pediatric epilepsy. The search was restricted to 2005-2021. A total of 920 cases were retrieved and screened for relevance.
Results:
A total of 44 cases were eligible for analysis. The plaintiff’s age was reported in 18 cases, with an average of 8.5 ± 5.9 years. Of 26 patients with reported sex, 15 (57.7%) were male and 11 (42.3%) female. The state with the greatest number of lawsuits was Pennsylvania (7, 15.9%). Eighteen (40.9%) cases involved suit of the hospital, while 9 (20.5%) involved emergency medicine, 4 (9.1%) neurology, and 2 (4.5%) neurosurgery. Ten (22.7%) cases involved patient death. The main complaints were medical error (26, 59.1%), failure to treat (24, 54.5%), failure to diagnose (10, 22.7%), misdiagnosis (2, 4.5%), lack of informed consent, (1, 2.3%) and other (4, 9.1%). Outcomes were 18 (40.9%) settlements, 17 defendant rulings (38.6%), 8 (18.2%) plaintiff rulings, and 1 dismissal (2.3%). Rulings in favor of the defendant (p=0.033) or settlements (p=0.015) were more frequent than those in favor of the plaintiff. There was no difference in payout between settlements ($4,040,000 ± 3,673,002) and plaintiff verdicts ($8,635,833 ± 6,947,914) (p=0.15).
Conclusion:
The data presented provide an overview of medical malpractice related to pediatric epilepsy. The information presented here may inform pediatric neurosurgeons regarding possible medicolegal consequences of treating epilepsy in children.