# Characterization of Litigation After Tympanoplasty and Mastoidectomy in the United States

## TL;DR

This study examines medical malpractice lawsuits in the U.S. following ear surgeries, finding that most cases are won by defendants, with facial nerve or brain injuries linked to plaintiff wins.

## Contribution

The paper provides a comprehensive characterization of litigation outcomes after tympanoplasty and mastoidectomy procedures in the U.S.

## Key findings

- Most cases (73.3%) were ruled in favor of the defendant.
- Facial nerve injury and brain injury or infection were the most common injuries.
- Injury to the facial nerve or brain was associated with plaintiff wins.

## Abstract

Introduction

Tympanoplasty and mastoidectomy are common procedures performed by otolaryngologists that can result in complications for which patients may seek compensation. Medical malpractice case analyses may offer insight into how clinicians can avoid risk and improve patient satisfaction. We aimed to comprehensively characterize litigation after mastoidectomies and tympanoplasties in the United States.

Methods

The Westlaw Campus Research legal database was searched for all available court decisions associated with claims of medical malpractice after tympanoplasty and/or mastoidectomy in the United States between 1975 and 2022. Information on the plaintiffs’ relationships to the patients, patient characteristics, states where the procedures took place, specialties of the defendants, allegations, surgical and postoperative complications, and adjudicated case outcomes was collected. Descriptive statistics were calculated.

Results

Fifteen cases that took place between 1976 and 2019 involving tympanoplasty (n = 2 (13.3%)), mastoidectomy (n = 4 (27.7%)), both tympanoplasty and mastoidectomy (n = 8 (53.3%)), and revision mastoidectomy (n = 1 (6.7%)) were reviewed. Most of the cases involved patients who were >18 years old (13/15 (86.7%)) and female (8/15 (53.3%)). An otolaryngologist was listed as a defendant in almost all cases (14/15 (93.3%)), and a hospital, surgery center, or otolaryngology practice was listed in 7/15 (46.7%) cases. The most common (13/15 (86.7%)) reason given for medical malpractice was negligent technique. Resulting injuries included facial nerve injury (5/15 (33.3%)), brain injury or infection (3/15 (20.0%)), death (2/15 (13.3%)), and a retained foreign body (1/15 (6.7%)). Most cases (11/15 (73.3%)) were ruled in favor of the defendant, and most (12/15 (80.0%)) were affirmed on appeal.

Conclusions

There are few claims of medical malpractice after tympanoplasty or mastoidectomy in the United States that are decided in court. Injury to the facial nerve or brain was associated with the plaintiff winning in the cases analyzed in this study.