More Cases Being Filed Involving Aortic Pathologies: More Medical Malpractice Cases Being Filed Against Vascular Surgeons: A study published online on December 19, 2022 entitled “An Analysis of Malpractice Litigation of Vascular Surgeons in Cases Involving Aortic Pathologies” that analyzed malpractice claims for aortic pathologies and assessed if there has been a change in rate of medical malpractice lawsuits with evolution of endovascular therapy concluded: “The proportion of litigation for clinical negligence in endovascular cases amongst all vascular surgical lawsuits is increasing.”
The study’s authors individually screened and compiled medical malpractice cases from the Westlaw database from 2000 to 2017 through use of relevant search terms. Data were collected of allegations, diagnoses, and outcomes of each case and compared. Of the 268 unique cases included in the study, aneurysms (54%, n = 145) and dissection (35%, n = 94) made up the majority.
The researchers found that there was a defense verdict in 53% (n = 141), plaintiff verdict in 24% (n = 65), and settlements in 23% (n = 62) of the medical malpractice lawsuits. Litigation was higher in the Midwest and Northeast. There was a gradual decline in medical malpractice litigation overall but endovascular case numbers remained constant. There was negligible difference in the primary allegation underlying the medical malpractice litigation for various aortic pathologies, time to litigation, and award between open and endovascular procedures.
Aortic Diseases
Diseases affecting the thoracic aorta can be categorized into chronic and acute. The most common pathologies are thoracic aortic aneurysm and dissection (TAAD), acute aortic syndrome (AAS), connective tissue diseases, and vasculitis. Despite the differences in pathophysiology of those diseases, hypertension and atherosclerosis are the main mechanisms behind their pathogenesis. Cholesterol and fat accumulation within the arteries accelerate the breakdown of collagen and elastin, thereby compromising strength, structure, and elasticity of the aortic wall. Hypertension, cigarette smoking, family history, and age are the main contributors to atherosclerosis and progressive aortic disease.
Vasculitis
Vasculitis is the inflammation of blood vessels and is an acute condition. The etiology in many cases is unknown. Sometimes it can be attributed to recent infection, especially of a viral nature. Thickening, narrowing, weakening, or scarring of the vessel wall is observed, which restricts blood flow. Takayasu’s arteritis (TA) and giant-cell arteritis (GCA) are subtypes of vasculitis and affect larger arteries such as the aorta.
Aortic Dissection
Another acute condition affecting the aorta is aortic dissection (AD). A tear in the intima allows blood flow into the media resulting in the development of a true lumen (TL) and a false lumen (FL), separated by an intimo-medial flap. Penetrating aortic ulcer (PAU), also an acute condition, is an outpouching of blood through the internal elastic lamina, typically arising from inflammatory erosion accompanying atherosclerotic plaque.
AD comprises the majority of cases of AAS and is characterized by severe, tearing chest pain radiating to the back. It has the highest mortality of the three with 80% of patients expected to die by the start of the third week. The condition can be categorized as being acute or chronic; duration of symptoms lasting > 14 days is the margin, past which symptoms are chronic by definition.
If you or a family member suffered serious injury as a result of medical negligence by a vascular surgeon in the United States, you should promptly find a local medical malpractice lawyer in your state who may investigate your vascular surgeon medical malpractice claim for you and represent you or your family member in a vascular surgeon medical malpractice case, if appropriate.
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