Necrotizing fasciitis and malpractice claims.

BACKGROUND

Necrotizing fasciitis (NF) is an aggressive bacterial infection of the superficial fascia and subcutaneous tissues that is increasing in incidence. The high toll exacted by this illness provides a setting for malpractice claims.

METHOD: We reviewed 180 consecutive malpractice claims submitted by attorneys for medical expert review between 1987 and late 1997. Four cases involved NF.

RESULTS

Alleged failure to obtain timely surgical consultation was the basis for three claims, and alleged failure to prevent NF by proper nursing care was the basis for the fourth. Three cases were closed and one was settled.

CONCLUSIONS

The cornerstone of risk management for a clinical presentation compatible with NF is immediate surgical consultation, with other diagnostic steps a secondary consideration.