Characterization of litigation after tonsillectomy in the United States

Background: Tonsillectomy is a common procedure performed for both adults and children. When unfavorable outcomes occur during perioperative events, patients may seek compensation through medical malpractice or medical negligence litigation. An understanding of these cases can help physicians and involved health care providers avoid risk and improve patient satisfaction. The aims of this study were to identify reasons for litigation after tonsillectomy and to examine outcomes of tonsillectomy-related litigation in the United States. Methods: All available court decisions associated with medical malpractice and negligence after tonsillectomy in the Westlaw Campus Research legal database were reviewed. The plaintiff' relationship to the patient, patient characteristics, state where the tonsillectomy took place, specialty of the defendant(s), allegations, and adjudicated case outcomes were obtained from case documents and analyzed. Results: Forty-two relevant judicial opinions written between 1986 and 2020 in 24 states were included. Twenty-two (52.4 %) of the cases involved female patients, and 24 (57.1 %) involved pediatric patients. Otolaryngology, anesthesiology, primary care, emergency medicine, orthodontics, and pharmacy were the disciplines involved in the negligence claims. Claims involved postoperative management in 18 (42.9 %) of the cases and intraoperative misadventure in 17 (40.5 %) of the cases. Six (14.3 %) of the 42 patients experienced an anesthesia complication, and 11 (26.2 %) experienced a surgical complication. Eleven (26.2 %) patients experienced postoperative bleeding. All cases involved postoperative concerns, and death occurred in 14 (33.3 %) of the patients. Overall, 21 (45.7 %) of the rulings were for the defendant. Conclusions: Postoperative management and intraoperative misadventure are commonly cited reasons for legal action after tonsillectomy procedures in the United States. All litigation surrounding tonsillectomy arose if concerns were present postoperatively. Thorough communication and attentive postoperative management are critical in order to avoid complications and patient injury, including death, associated with tonsillectomy.