Even A Worm Will Turn: Appendicitis Malpractice Litigation Since 2020

Abstract

Background: Appendicitis is the inflammation of the vermiform appendix, and it is the most common abdominal surgical emergency in the world. Its diagnosis, however, has many pitfalls including lack of a pathognomonic sign or symptoms, and the low predictive value of laboratory testing. Appendicitis is a leading cause of malpractice concerns. Methods: Using Google Case Law, we used the search terms appendicitis, and malpractice to identify appendicitis litigation cases. We included cases published since 2020. We included any case where a confirmed diagnosis of appendicitis was made. We included cases filed for malpractice due to complications of appendicitis and its treatment. Outcomes of interest included: the state the case was published, the defendants, the date of when the patient first complained of abdominal pain to when they had had an appendectomy/treatment, diagnostics and consultations, medical and legal issues, and final verdict/opinion/decisions on the cases. Results: A total of 44 cases were identified, which were screened for inclusion. A total of 14 cases met the inclusion criteria and were analyzed. Most cases did not present in an atypical way, the majority of patients presented with clear statements of abdominal pain of varying severity. The majority of the defendants were MDs and hospitals. The average time from symptom to diagnosis was 2.4 +/- 2.1 days, while the longest time for diagnosis was 7 days. The leading medico-legal issues were failure to diagnose and delayed diagnosis, while among the cases, 35.7% had outcomes in favor of the plaintiff. Conclusions: Appendicitis remains an area of high risk of litigation. Malpractice suits are often due to failure to diagnose and failure to treat, but there maybe proactive measures to address the modern pitfalls to promote a decreased litigation risk and patient safety