Medical Malpractice Against Pediatric Orthopaedic Surgeons: An Analysis of Clinical and Legal Characteristics Over a 20-Year Period.

Background: Surgical specialties such as orthopaedic surgery are subject to a disproportionate number of medical negligence cases per year. Cases involving pediatric orthopaedic conditions or plaintiffs who are minors constitute a small portion of orthopaedic malpractice cases but consistently demonstrate the highest payouts or plaintiff verdicts. By querying the Westlaw Legal database, this study aims to characterize cases involving fellowship-trained, board-certified, pediatric orthopaedic surgeons as the defendants. Methods: A retrospective query spanning 20 years (1/1/2004-12/31/2023) of the Westlaw Legal Database was conducted using the following search terms: "orthopaedic" or "orthopaedic" or "orthopedist" and "pediatric" and "malpractice." Twenty-two cases were identified after the exclusion of cases with insufficient data, adult plaintiffs, orthopaedic surgeons not specialized in pediatrics, or duplicate cases. Clinical and legal characteristics were collected and stratified by case outcome: plaintiff verdict, settlement, or defendant verdict. Descriptive statistics were utilized for data analysis. Results: Twenty-two cases were found against pediatric orthopaedic surgeons resulting in a defendant (surgeon) win in 12, loss in 8, and settlement in 2 cases. The mean age of the plaintiffs was 12.1 ± 4.5 years, and 63.6% were female. The most common initial injury sustained was a fracture, and 86.4% of cases involved surgical intervention. The largest number of cases occurred in New York and in the year 2004. Pediatric orthopaedic surgeons were named as the sole defendant in 68.1% of cases. The reason for litigation was most commonly cited as negligent surgery/treatment resulting in irreversible damage in 7 (31.8%) occurrences. In cases resulting in verdict or settlement payout, the mean and median payout was $18,183,822 ± $47,888,835 and $990,000 and $155,000 ± $56,568 and $155,000, respectively. Conclusions: Keeping in mind the database limitations, litigation against pediatric orthopaedic surgeons has been infrequent over the past twenty years. However, specialists must remain vigilant due to the significant risk that still exists. The orthopaedic care of the pediatric population requires a high level of care and consideration to avoid devastating results for both the patient as well as the physician. Key Concepts: (1)Nearly half of medical malpractice cases against pediatric orthopaedic surgeons have resulted in indemnity or settlement payout.(2)In most cases, the plaintiffs were initially diagnosed with fractures and the predominant course of treatment involved surgical intervention.(3)Negligent treatment resulting in either reversible or irreversible damage was the most commonly cited type of medical negligence.(4)Cases in which the pediatric orthopaedic surgeon lost resulted in substantial payouts. Level of Evidence: III.