• Marc Colaco, Matthew Heavner, Peter Sunaryo, and Ryan Terlecki.
• Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
• J Emerg Med. 2015 Dec 1; 49 (6): 849-54.

BackgroundThe litigious nature of the American medical environment is a major concern for physicians, with an estimated annual cost of $10 billion.ObjectiveThe purpose of this study is to identify causes of litigation in cases of testicular torsion and what factors contribute to verdicts or settlements resulting in indemnity payments.MethodsPublicly available jury verdict reports were retrieved from the Westlaw legal database (Thomson Reuters, New York, NY). In order to identify pertinent cases, we used the search terms "medical malpractice" and "testicular torsion" with date ranging from 2000 to 2013. Jury verdicts, depositions, and narrative summaries were evaluated for their medical basis, alleged malpractice, findings, and indemnity payment(s) (if any).ResultsFifty-two cases were identified that were relevant to this study. Fifty-one percent of relevant cases were found in favor of the defendant physician, with the remaining 49% involving an indemnity payment (13% of which were settled). The most commonly sued medical providers were emergency physicians (48% of defendants), with urologists being second most common and making up 23% of the defendant pool. Emergency physicians were significantly more likely to make indemnity payments than urologists.ConclusionTesticular torsion is a delicate condition and requires expertise in evaluation and treatment. When emergency physicians choose not to consult an urologist for possible torsion, they leave themselves open to litigation risk. When an urologist is involved in torsion litigation, they are rarely unsuccessful in their defense. Finally, ultrasound is no guarantee for success against litigation.Copyright © 2015 Elsevier Inc. All rights reserved.

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