Legal Lens on Hysteroscopy: A Retrospective Review of Medical Malpractice Claims of Hysteroscopic Procedures.

Background

Given the expansiveness of diagnostic and therapeutic hysteroscopy, promptly recognizing complications and intervening as necessary to prevent adverse outcomes and minimize legal risk is imperative. We aim to describe the litigious trends in hysteroscopic procedures across the United States;

Methods

Publicly available lawsuits published on a well-known legal database, Westlaw, were reviewed. The search term "'hysteroscop!'" was used to filter cases for court opinions containing words with this prefix, including "hysteroscopy", "hysteroscopies", and "hysteroscopic." Adverse events, procedural outcomes, post-procedural surgery urgency, and resultant disabilities were extracted for themes;

Results

The primary complication resulting in legal action was uterine perforation (52.9%), followed by claimed technical mistakes (23.5%) and damage to surrounding structures (11.8%). The most common outcome was the need for future corrective surgery (70.6%), and a number of cases resulted in permanent brain damage or death (23.6%). Of the patients that required subsequent corrective surgery (n = 12), 91.7% of them required emergent surgery. Patients sought damages most commonly from individual attending providers (41.2%), attending physician and practice groups/hospitals collectively (41.2%), and additional entities, including resident physicians in training and manufacturers. Awards ranged from $322,308 to $9,387,109;

Conclusions

Medical malpractice litigation is challenging to patients and providers alike, often leading to financial, emotional, and professional burden. Our evaluation highlights the variability in adverse events from hysteroscopy which prompt litigation, financial burden of lawsuits, and legal risk of individual providers, in an attempt to improve safety of future procedures.