Medicolegal characteristics of aortic stenosis litigation: a review of the LexisNexis Academic database.

BACKGROUND AND AIM OF THE STUDY: Currently, few studies have been conducted to assess the outcome patterns of medicolegal cases involving patients with cardiovascular disease. Thus, the literature was reviewed for patterns of liability and medical outcomes in patients involved in aortic stenosis (AS) litigation.

METHODS

Legal case opinions were obtained from LexisNexis Academic; case characteristics, litigation outcomes, and medical outcomes were identified.

RESULTS

Of the 133 cases reviewed, 27% were disability claims, 23% workers' compensation cases, 14% medical malpractice cases, and 9% military service connection cases. Of the 133 cases, only 47% were judged in the patients' favor. The patients' mean age was 48.8 years, and 77% were male. The most common etiology of AS was calcific (38%), followed by rheumatic (31%), bicuspid/congenital (27%), and subaortic (4%). The most common presentation was precordial pain (38%), shortness of breath (35%), syncope/dizziness (18%), fatigue (11%) and death (9%). Aortic valve replacement (AVR) was the most common form of treatment (67%); disability was the most common medical outcome (42%).

CONCLUSION

AS in litigation follows the standard pattern of AS disease. Only a minority of AS litigation cases are due to medical malpractice, while the majority of AS litigation cases are due to those seeking workers' or disability compensation. Cardiologists treating patients with AS should be cognizant of these litigation patterns and proactively document medical findings, since resulting court decisions profoundly affect the patients' financial means and quality of life.