Ann Surg Treat Res.  2020 Sep;99(3):131-137. 10.4174/astr.2020.99.3.131.

Medicolegal implications from litigations involving necrotizing fasciitis

• Kim MJ
• Shin SH
• Park JY

• KMID: 2505482
• DOI: http://doi.org/10.4174/astr.2020.99.3.131

Abstract

Purpose
Necrotizing fasciitis (NF) is one of the most severe healthcare-associated infections. Early diagnosis of NF is difficult because of nonspecific signs and symptoms in the early stage. NF often presents with risks of medicolegal disputes. This study aimed to provide baseline data on the general characteristics of medical accidents involving NF, features of NF, and typical court opinions regarding medical malpractice in Korea.
Methods
In this study, 25 cases of medical malpractice litigation involving NF sentenced between 1998 and 2018 were analyzed with respect to 3 variables: medical accident, NF, and breach of duty.
Results
The department of colorectal surgery was most frequently involved in litigation cases (40.0%), and colorectal surgery was the most frequent procedure before the diagnosis of NF (40.0%). The most common sites were the upper and lower extremities. The courts agreed that there was typically improper monitoring after treatment, frequently related to NF.
Conclusion
These litigation cases imply that physicians cannot be blamed for the failure to prevent NF. The timely recognition and management of NF might be considered as one of the main factors for deciding malpractice in court.Therefore, surgeons, especially in the department of colorectal surgery, should pay attention to changes in the patient’s status after surgery. Surgeons need to learn from medical accidents, as it is important for risk management, preventing the occurrence of similar cases, and improving the quality of healthcare services. We report the medicolegal implications from medical lawsuits involving NF.

Keyword

Infections; Legal liability; Litigation; Malpractice; Necrotizing fasciitis

Figure

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  Fig. 1 Flow diagram for case selection.

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  Fig. 2 Yearly distribution of cases of necrotizing fasciitis.

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  Fig. 3 Limitation of liability (17 total cases).

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  Fig. 4 Procedure before the diagnosis of necrotizing fasciitis.

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  Fig. 5 Complication site of the necrotizing fasciitis.

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  Fig. 6 Recognized breach of duty of care involving the occurrence of necrotizing fasciitis (NF). The length of the bar means the number of cases approved breaches of duty of care by the court.

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