A tough pill to swallow: Medicolegal liability and dysphagia.

LEVEL OF EVIDENCE: Level 4 (Case Series).

OBJECTIVE

Dysphagia is a debilitating condition that is associated with many etiologies. It can have a devastating effect on a patient's quality of life with long-term sequelae that make it a source of medical malpractice litigation. This study analyzed medical malpractice cases involving dysphagia and looked for factors determining legal liability.

METHODS

The Westlaw Next legal database (Thomson Reuters, New York, NY) was searched for relevant malpractice cases and assessed for several factors including if the dysphagia was iatrogenic, the amount paid by the defendant, and the medical specialty of the defendants.

RESULTS

A total of 45 cases of dysphagia were included. The majority of these cases were jury verdicts for the defendant (73.3%). Iatrogenic dysphagia was alleged in 55.5% of cases. Settlements and verdicts favoring the plaintiff resulted in awards ranging between $25,000 and $5,003,000 with a mean of $1,014,015. The most frequent physician specialists named were general surgeons (24.1), internists (11.1%), anesthesiologists (9.3%), gastroenterologists (7.4%), and otolaryngologists (5.6%). Iatrogenic dysphagia (OR 8.89 CI 1.02-77.32), medication-related iatrogenesis (OR 18.86 CI 1.82-195.41), and cases naming multiple specialties as a defendant (OR 5.90, CI 1.07-32.55) were factors associated with a verdict for the plaintiff or a settlement.

CONCLUSION

Dysphagia is a condition with medicolegal consequences for many specialties. While the majority of these cases are decided in favor of the defendant the cost of a negative outcome is considerable. Iatrogenic dysphagia and naming more than one defendant specialty were associated with increased odds of a plaintiff verdict or settlement.