KISSIMMEE, FLA. – Many of the leading causes of litigation associated with cutaneous laser surgery are preventable, findings from a comprehensive legal database search suggest.
For example, 17 cases of litigation identified by the search were associated with a failure to conduct a test spot on a patient undergoing laser hair removal, and this deficiency went "almost hand in hand" with failure to evaluate skin type, Dr. H. Ray Jalian, a clinical fellow at Massachusetts General Hospital, Boston, said at the annual meeting of the American Society for Laser Medicine and Surgery.
Failure to obtain informed consent was also a common – and preventable – cause of litigation among the 182 cases that Dr. Jalian and his colleagues identified during their online search of more than 40,000 documents. All of the cases involved injury associated with cutaneous laser therapy and occurred between 1989 and 2012.
The search, conducted in "an effort to close practice gaps and minimize the risk of future lawsuits for laser surgeons," was performed using keywords such as laser, laser and skin, laser and malpractice, laser and hair, laser and tattoo, and intense pulsed light accident.
Burns were the most common type of injury associated with litigation, followed by scars, pigmentation, and disfigurement. Some cases also listed emotional distress and physical suffering. There were four cases involving eye injury, and two cases of death – both associated with anesthesia complications. One of these cases involved a patient who underwent general anesthesia for classic CO2 resurfacing, and the other involved an anaphylactic reaction to topical lidocaine, Dr. Jalian said.
The most common type of procedure associated with litigation was hair removal, followed by various types of rejuvenation, treatment of leg veins, tattoo removal, and treatment of vascular lesions, neoplastic scars, and pigmentary disorders. The most common cause of action was negligence, followed by treatment below the standard of care, lack of informed consent, loss of consortium, and assault and battery. Poorly trained – or untrained – staff, and improper use of appropriate lasers and/or laser settings were also among the complaints.
Of the cases for which a summary judgment, verdict, or settlement was made public, about half were in favor of the defendant and half were in favor of the plaintiff. Monetary awards ranged from $5,000 to over $2,000,000 for a case involving burns and hyperpigmentation secondary to a classic C02 resurfacing case, Dr. Jalian noted.
Although the findings are limited by the use of a single database, they do highlight the fact that there are several preventable causes of litigation – an important consideration for all laser surgeons, given that 75% of all physicians – and close to 100% of those in high risk specialties – will face a medical malpractice lawsuit during their careers, he said.
Dr. Jalian had no disclosures to report.