# Fifteen Years of Orthopedic Malpractice Litigation in Türkiye: A Supreme Court Analysis and International Comparison

## TL;DR

This study analyzes 15 years of orthopedic malpractice cases in Türkiye's Supreme Court to identify patterns and compare them with global trends.

## Contribution

The study provides the first detailed analysis of high-court orthopedic malpractice decisions in Türkiye and compares them internationally.

## Key findings

- Negligent injury was the most common allegation in orthopedic malpractice cases.
- The Supreme Court overturned nearly half of the initial court decisions.
- Diagnostic delay and postoperative complications were leading litigation themes.

## Abstract

Background/Objectives: Orthopedic surgery is among the most frequently litigated medical specialties worldwide. However, high-court malpractice decisions involving orthopedic specialists in Türkiye remain underexplored. This study aims to identify the patterns, causes, and outcomes of malpractice cases involving orthopedists by analyzing Turkish Supreme Court decisions over the past 15 years. Methods: A retrospective review of orthopedic malpractice cases adjudicated by the Turkish Court of Cassation between January 2010 and November 2025 was conducted. Variables included type of alleged offense, clinical context, primary/secondary liability, initial court outcomes, high-court decisions, and fault attribution. Findings were compared with international literature to contextualize national patterns. Results: A total of 71 decisions were analyzed. Negligent injury was the most common allegation. Initial acquittal and conviction rates were 50.7% and 49.3%, respectively. The Supreme Court affirmed 53.5% of decisions and overturned 46.5%. Fault was attributed to orthopedic specialists in 29.6% of cases, while 40.8% were found faultless; the remaining cases required additional expert evaluation. Litigation themes included diagnostic delay, postoperative complications, inadequate monitoring, and documentation deficiencies. Comparative analysis revealed substantial alignment between Turkish and international malpractice patterns. Conclusions: Orthopedic malpractice litigation in Türkiye mirrors global trends, with most claims stemming from trauma-related care and diagnostic errors. Although many cases undergo prolonged appeals, ultimate conviction rates remain low. Strengthened documentation, improved communication, and enhanced clinical guideline adherence may reduce litigation risk and improve patient safety.