An article presented during the 2019 meeting of the American Urological Association (AUA) reported “Most kidney stone-related malpractice suits end in a verdict in favor of the physician or a hospital, even after appeal.”
The investigators analyzed 33 appealed medical malpractice cases involving kidney stones. Patients or their spouses were the plaintiff in 23 (70%) of the kidney stone medical malpractice cases and patients’ estates were the plaintiffs in 10 (30%) of the cases. Urologists and non-urologist providers were the defendants in 19 of the cases (67%) and 10 of the cases (30%), respectively. Associated hospitals were named in 21 of the cases (64%).
The investigators found that of the 33 kidney stone malpractice cases, 28 (85%) alleged an error of treatment as the primary negligence.
The investigators found that the defendants prevailed in 21 (63%) of he kidney stone malpractice cases. Only four trials involved payments to a plaintiff, with the average payout in excess of $1 million per case and the range of payouts from a low of $193,000 to a high of $3 million. Ten (30%) of the cases were reversed on appeal. The investigators also found that the defendant prevailed initially and on appeal in the majority of cases.
Nephrolithiasis Malpractice Cases
Nephrolithiasis is the presence of stones within the kidney. Urolithiasis is a more general term for stones anywhere within the urinary tract. Kidney stones develop when crystals separate from the urine and aggregate within the kidney papillae, renal pelvis, or ureter. The most common type of stones are calcium-containing stones, which are usually formed of calcium oxalate and less commonly of calcium phosphate. Other metabolic stones include uric acid, cysteine and xanthine stones. The age of peak incidence for kidney stone disease is 20 to 40 years, although stones are seen in all age groups. There is a male to female ratio of 3:2.
Most kidney stones pass within a few days with conservative treatment, including adequate fluid intake and analgesia. Others may take longer to pass and the observation period can be extended to 3-4 weeks where appropriate. Ureteric stones less than 5 mm in diameter will pass spontaneously in about 90% of people, compared with 50% of ureteric stones between 5 mm and 10 mm. Conservative management is considered on an individual basis in people with stones that are asymptomatic, very small, or both (although stone size may not correlate with symptom severity), and in people with significant comorbidities in whom the risks of treatment may outweigh the likely benefits.
Stones may migrate regardless of treatment or after treatment for their removal, and may or may not present clinically once in the ureter. Stones blocking the urine flow may lead to hydronephrosis and renal atrophy. They may also result in life-threatening complications including urinary infection, perinephric abscess, or urosepsis. Drainage of an infected obstructed kidney is a medical emergency and may result in death if left untreated. Infection may also occur after invasive procedures for stone removal. Some of these complications may cause kidney damage and compromised renal function. Eventually, 10%-20% of all kidney stones need treatment.
If you or a loved one may have been injured as a result of kidney stone malpractice in the United States, you should promptly find a medical malpractice lawyer in your U.S. state who may investigate your kidney stone medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
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