When Things Go Wrong: A Guide to the Medical, Ethical, and Legal Dimensions of Surgical Complications.

Abstract

Surgical complications remain an unfortunate inevitability of surgical practice. When adverse events arise, orthopaedic surgeons must be prepared to navigate the complex medical, ethical, and legal dimensions through a multifaceted response. Prompt communication and collaboration with the risk management team, along with proper documentation, are essential. The art of disclosure must be guided by compassionate yet candid discussions that focus on transparency and accountability. The effects of complications transcend the confines of the operating room, affecting not only patients and their families but also orthopaedic surgeons. Without adequate support, the emotional consequences experienced by surgeons involved in the adverse event can lead to devastating cascading effects, which negatively affect job performance and patient care due to maladaptive coping mechanisms. To ameliorate these issues, programs have been developed to improve the psychological and personal well-being of healthcare providers after adverse events, shifting toward a nonpunitive culture that emphasizes improvement rather than blame. In light of the absence of a roadmap for orthopaedic surgeons facing complications, this review is dedicated to presenting a comprehensive guide for navigating such events when they arise, while also highlighting the effect of these challenges on surgeons and potential avenues for their support and improvement.