Progress in cardiovascular diseases · 2025
Medicolegal implications and litigation trends in the diagnosis and management of cardiomyopathies in the United States.
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Weller Samantha L, Costa Andrew, Suits Austen, Zia Abdul, Petek Bradley J, Masri Ahmad
Аннотация
BACKGROUND: Cardiomyopathies encompass a heterogeneous group of myocardial diseases with variable clinical manifestations and prognoses. Despite their complexity and association with high-risk outcomes, malpractice claims related to cardiomyopathies have not been well-characterized.
OBJECTIVE: To characterize medicolegal claims associated with non-ischemic cardiomyopathies in the United States and identify common clinical and systemic contributors to liability.
METHODS: A retrospective review of U.S. malpractice and negligence claims from inception to 2025 was conducted using Westlaw, vLex, and a sports cardiology litigation database. Included cases involved a diagnosis or clinical suspicion of cardiomyopathy directly linked to a legal claim. Case frequency, location, demographics, allegations, defendant profiles, and outcomes/awards were identified for all eligible cases.
RESULTS: Of 421 cases reviewed, 63 (15 %) met inclusion criteria, spanning 1990-2025 with 1.8 cases/year. Hypertrophic (38 %) and dilated (31 %) cardiomyopathies were the most frequently litigated subtypes. Sudden cardiac arrest/death occurred in 79 % of cases. Leading allegations were failure to diagnose cardiomyopathy (37 %), inappropriate treatment (27 %) and communication failures (19 %). Non-cardiology providers, particularly primary care, were the most frequently named defendants (83 %), while cardiologists were implicated in 29 % of cases. Incarcerated individuals accounted for 16 % of cases. Most outcomes favored defendants (54 %), while 13 % resulted in plaintiff-favorable verdicts or settlements, with awards ranging from $100,000-$21,568,710 ($200,999 - $28,039,323 adjusted for inflation).
CONCLUSION: While rare, malpractice claims related to cardiomyopathies are often associated with preventable failures in diagnosis, treatment and communication. These findings underscore the need for improved provider education, standardized diagnostic pathways, and clinical decision support tools to mitigate liability and enhance patient safety.
OBJECTIVE: To characterize medicolegal claims associated with non-ischemic cardiomyopathies in the United States and identify common clinical and systemic contributors to liability.
METHODS: A retrospective review of U.S. malpractice and negligence claims from inception to 2025 was conducted using Westlaw, vLex, and a sports cardiology litigation database. Included cases involved a diagnosis or clinical suspicion of cardiomyopathy directly linked to a legal claim. Case frequency, location, demographics, allegations, defendant profiles, and outcomes/awards were identified for all eligible cases.
RESULTS: Of 421 cases reviewed, 63 (15 %) met inclusion criteria, spanning 1990-2025 with 1.8 cases/year. Hypertrophic (38 %) and dilated (31 %) cardiomyopathies were the most frequently litigated subtypes. Sudden cardiac arrest/death occurred in 79 % of cases. Leading allegations were failure to diagnose cardiomyopathy (37 %), inappropriate treatment (27 %) and communication failures (19 %). Non-cardiology providers, particularly primary care, were the most frequently named defendants (83 %), while cardiologists were implicated in 29 % of cases. Incarcerated individuals accounted for 16 % of cases. Most outcomes favored defendants (54 %), while 13 % resulted in plaintiff-favorable verdicts or settlements, with awards ranging from $100,000-$21,568,710 ($200,999 - $28,039,323 adjusted for inflation).
CONCLUSION: While rare, malpractice claims related to cardiomyopathies are often associated with preventable failures in diagnosis, treatment and communication. These findings underscore the need for improved provider education, standardized diagnostic pathways, and clinical decision support tools to mitigate liability and enhance patient safety.