Knot Guilty? An Examination of Testicular Torsion Litigation Trends from 2014 to 2022

Abstract Background: Testicular torsion is a true urological emergency that occurs when the testes twists around the spermatic cord, cutting off its blood supply. The failure to diagnose testicular torsion is a common medicolegal pitfall due to the uncertainty and urgency of the diagnosis and the potential for testicular loss. In this study, we examined the current medicolegal cases that involved testicular torsion using the LexisNexis database for all cases from 2014 to 2022, using the search terms testicular torsion and medical malpractice. Our final examination included a total of 20 cases. Results: Trends reveal that Emergency doctors and urologists are the most commonly named defendants. Adults and incarcerated persons are common plaintiffs. The average time from presentation to diagnosis of testicular torsion was 8+/-13 days. The right testicle was the most commonly implicated, and a misdiagnosis was a commonly cited. The average time from testicular torsion diagnosis to filing a case was 4.35 years. Conclusions: Trends reaffirm that testicular torsion remains a high risk of litigation diagnosis, and continued training and education may be needed to remedy the medicolegal pitfalls for this emergency condition. Keywords: Testicular Torsion, Litigation, Pediatric, Emergency, Malpractice, Medicolegal