Orthopedic surgeons are at a higher risk of being named in a malpractice lawsuit than other specialists. By knowing the incidents that are most likely to trigger malpractice allegations, orthopedic surgeons can better understand the risks of their specialty and how to address them proactively.

Iatrogenic injuries increase an orthopedic surgeon’s malpractice risk

Orthopedic surgery can be life changing for persons with chronic joint pain and limited mobility. According to an iData Research report, orthopedic surgeons in the U.S. perform over 1 million total knee and hip replacements annually, plus an estimated 1.62 million spinal procedures and over 300,000 interbody fusions.

While every type of surgery carries the risk of complications, the frequency and complexity of these orthopedic procedures heighten the possibility of iatrogenic injuries to the patient — and increase the orthopedic surgeon’s exposure to medical malpractice litigation. This article takes a look at the surgical complications most often named in malpractice claims and discusses ways to potentially reduce the risks for patient and surgeon alike.

Understanding the risk for orthopedic malpractice suits

Orthopedic surgeons rank among the top 10 surgical specialties most likely to be sued for malpractice.

The nature of the high-risk surgeries on the spine, knees, hips, hands, and feet in particular place high expectations for achieving the best outcomes of pain relief and restoring mobility. Because these procedures affect the patient’s ability to stand, walk, and perform everyday tasks, interoperative and post-surgical complications can be devastating to the patient’s physical well-being and quality of life.

Ironically, the types of orthopedic surgeries that are sought out most often by patients suffering back pain or joint issues are among the most risky – total knee and hip replacement, spinal fusion and laminectomy, and procedures on the hand and foot.

Specific types of orthopedic issues or injuries presented by the patient, and the complexity of the surgeries to correct them, can make orthopedic surgeons potentially more vulnerable to being sued.

Common Injuries Associated with Orthopedic Surgery Malpractice Claims

  • Spinal stenosis

  • Herniated lumbar disk

  • Compression of nerves in the lower spine

  • Knee ligament damage or injury

  • Hip fracture

  • Achilles tendon rupture

  • Scaphoid fractures of the wrist

Top Orthopedic Errors That Trigger Medical Malpractice Claims

According to the Medscape Orthopedist Malpractice Report 2021, surgical complications and injuries were indicated by 54% of the respondents as the primary reason for a malpractice suit against them. Poor surgical outcomes were the second most common reason, with failure or delay in diagnosing as the third. Orthopedic conditions most commonly misdiagnosed include ACL tears, Achilles tendon ruptures, femoral neck stress fractures, and scaphoid fractures.

A survey of malpractice claims by The Doctors Company found that the top three major surgical injuries were related to “an aggravated or worsened preoperative condition”, including pain, mobility, nerve damage, and postoperative pain.

Other potential orthopedic errors that most often trigger malpractice litigation include:

Common Errors Associated with Orthopedic Malpractice Claims

  • Misinterpreting CT scans and other diagnostic scans

  • Performing surgery on the wrong body part

  • Implants inserted incorrectly

  • Failure of implant components

  • Postoperative implant or prosthesis infections

  • Increased risk of bleeding in spinal surgeries and total joint replacement

  • Neurovascular injury to nerves or blood vessels around the knee

  • Sciatic nerve injury in hip replacements

  • Failure to achieve pain relief

  • Deep vein thrombosis developing into pulmonary embolism in total hip and knee replacements and hip fracture procedures

  • Failure to identify surgical site infections and other post-surgical complications

How Orthopedic Surgeons Can Reduce the Risk of Malpractice and Improve Patient Outcomes

All surgeries carry some risk for the patient, and even the most experienced and skilled surgeons encounter unexpected surgical complications. Engaging an experienced medical malpractice insurance broker to find the right coverage for your surgical specialty and practice is the first step in mitigating your professional and personal financial risk.

The Medscape Orthopedist Malpractice Report 2021 indicated that monetary awards of $100,000 to $500,000 were paid in orthopedic malpractice cases that were either settled or found in the plaintiff’s favor at trial. Plaintiffs were awarded up to $2.37 million in cases in which orthopedic sports medicine surgeons were sued for interoperative error.

Based on malpractice claim studies by The Doctors Company, here are a few other ways that you can potentially reduce some of the risk factors and improve outcomes for your orthopedic patients – and reduce your own exposure to malpractice suits:

  • Create a “prescreening” protocol in which you focus on “modifiable risk factors” and set expectations for surgical outcomes with the patient and family members. Talk to patients to confirm that they understand the risks and give informed consent. Overall, build a trusted relationship with each patient, and foster timely and responsive communication between the patient and your practice.

  • Keep meticulous records of every patient encounter, pre- and post-surgery. Document all treatments, procedures, and outcomes in the patient’s medical record precisely and in a timely manner. If you are sued for malpractice, lawyers will want to review all of the medical records pertaining to the claim. It’s to your advantage to have them well-documented and complete.

Need Medical Malpractice Insurance for Your Orthopedic Surgery Practice? SURGPLI can Help.

At SURGPLI, our experienced insurance brokers understand the robust coverage requirements of malpractice insurance for orthopedic surgeons. Let us help you choose the right policy for your needs from AM Best “A” rated carriers. Get a fast quote or call 1-800-969-1339

SURGPLI is a division of MEDPLI, an independent insurance brokerage that specializes in making medical malpractice insurance simple for doctors.

Max Schloemann

About the Author

Max Schloemann is a medical malpractice insurance broker, focused on helping physicians secure Medical Professional Liability coverage. He helps Doctors and Surgeons, as well as Physician Assistants, Nurse Practitioners, and healthcare entrepreneurs launch new medical practices across the country. Max graduated Magna cum Laude from Southern Illinois University College of Business and was named the Outstanding Management Senior. Max’s career in medical malpractice insurance began in 2008 with an industry-leading firm. Max founded SURGPLI in 2023 to help surgeons navigate the complexities of medical malpractice insurance in the new era of healthcare. Max’s wife, Kristen, a Physician Assistant, and their 4 kids (plus 1 dog) enjoy hiking, golf, and cooking.

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