Litigation in Cubital Tunnel Surgery.

Background: Medical malpractice is common, costly, and poorly understood within the U.S. health care system. Cubital tunnel release (CuTR) is the second most common nerve surgery and is prone to complication. Malpractice claims associated with carpal tunnel surgery, distal radius fractures, replantation, and the field as a whole have previously been studied. To date, there has been no study of litigation related to CuTR independently; the aim of this paper is to do so.

Methods: The Lexis+ (LexisNexis, New York, NY) legal database was queried for all cases relating to CuTR. Thirty-five cases were identified that were directly related to CuTR; these were amended with publicly available data on defendant specialty and training and statistically examined.

Results: Around 51% of cases favored the defendant, 37% favored the plaintiff, and 11% were resolved with a settlement. Median, maximum, and minimum award amounts were $415 484, $11 464 991, and $180 000, respectively. Awards significantly differed by claim type, with large awards for incorrect surgery ($1 007 500), negligent surgery ($389 969), and poor post-op care ($11 464 991). There were no significant differences in outcomes or award amounts by specialty type, hand surgery training, years of experience, or simultaneous surgeries; however, surgeons with hand training had lower median awards ($400 854 vs $430 114), and there were lower awards for simultaneous surgeries ($372 997 vs $445 047).

Conclusions: Cubital tunnel release appears to carry a higher liability than other procedures within hand surgery such as carpal tunnel release.