• Nathan W Mesko, Jennifer L Mesko, Lauren M Gaffney, Jennifer L Halpern, Herbert S Schwartz, and Ginger E Holt.
• Investigation Performed at Vanderbilt University Medical Center, Department of Orthopaedic Surgery, Musculoskeletal Oncology Division, Nashville, Tennessee.
• J Surg Oncol. 2014 Dec 1;110(8):919-29.

BackgroundWe reviewed medico-legal cases related to extremity sarcoma malpractice in order to recognize those factors most commonly instigating sarcoma litigation.MethodsOver one million legal cases available in a national legal database were searched for malpractice verdicts and settlements involving extremity sarcoma spanning 1980-2012. We categorized verdict/settlement resolutions by state, year, award amount, nature of the complaint/injury, specialty of the physician defendant, and academic affiliation of defendant-amongst other variables.ResultsOf the 216 cases identified, 57% of case resolutions favored the plaintiff, with a mean indemnity payment of $2.30 million (range $65,076-$12.66 million). Delay in diagnosis (81%), unnecessary amputation (11%), and misdiagnosis (7%) accounted for the majority of complaints. The greatest numbers of claims were filed against primary care specialties (34%), orthopaedic surgeons (23%), and radiologists (12%). Individual state tort reform measures were not protective against case resolution outcome.ConclusionsReported medico-legal claims involving sarcoma care continue to rise, with mean indemnity payments approaching 10 times that for other reported medical/surgical specialties. Primary care and orthopaedic specialties are the most commonly named physician defendants, citing a delay in diagnosis. This suggests further education in the front line diagnosis and management of sarcomas is needed.© 2014 Wiley Periodicals, Inc.

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