In a cross-sectional study of malpractice and medical liability claims for cutaneous energy-based device procedures, researchers found that the most litigated health professionals were plastic surgeons, and the most commonly affected anatomical sites were the face, head, and/or neck.
“The use of laser and energy-based devices (LEBD) has grown substantially,” wrote corresponding author Scott Stratman, MD, MPH, and co-authors in their study, published online in the Journal of the American Academy of Dermatology, “leading to a rise in practitioners, both physicians and non-physicians, who may lack the requisite training in LEBD procedures.”
For their study, the team had queried the LexisNexis database from 1985 to 30 September 2023 for all state, federal and appellate cases that included the terms “negligence” or “malpractice” and “skin” and “laser”.
After they removed duplicate cases and excluded cases that did not report dermatologic complications or cutaneous energy-based procedures, the final analysis included 75 cases, reports Medscape.
Most of the appellants/plaintiffs (66 [88%]) were women, and the most common anatomical sites were the face, head, and/or neck: 43 of the cases (57.3%) were decided in favour of the appellee/defendant or the party defending against the appeal, while 29 (38.7%) were in favour of the appellant/plaintiff or the party appealing. Three cases (4%) did not report a verdict.
In other findings, plastic surgeons were the most litigated healthcare professionals (18 [24%]), while 39 of the overall cases (52%) involved non-physician operators (NPOs), 32 (42.7%) involved a physician operator, and four cases (5.3%) did not name a device operator.
The most common procedure performed in the included cases was laser hair removal (33 [44%]).
Complications from energy-based devices included burns, scarring, and pigmentation changes. Statistically significant associations were neither found between verdict outcome and appellee/defendant type nor found between energy-device operator or anatomical site.
The researchers said that as the demand for these procedures – and the number of practitioners performing them – increases, “it remains paramount to characterise the trends of malpractice cases involving these procedures”.
Stratman, a dermatology resident at the Icahn School of Medicine, New York City, and colleagues said they acknowledged certain limitations of the study, including the fact that the LexisNexis database does not contain cases handled in out-of-court settlements and cases that underwent third-party arbitration.
However, “physicians must recognise their responsibility when delegating procedures to NPOs and their role in supervision of these procedures”, they said.
“Comprehensive training for physicians and their agents is necessary to diminish adverse outcomes and legal risks.
“Moreover, all practitioners should be held to the same standard of care. Familiarity with malpractice trends not only strengthens the patient-provider relationship but also equips providers with effective strategies to minimise the risk of legal repercussions.”
Mathew Avram, MD, JD, director of laser, cosmetics, and dermatologic surgery at Massachusetts General Hospital, who was not involved in the study, said that it “reaffirms previous studies which show that laser hair removal continues to be the most litigated procedure in laser surgery, and that non-physician operators are most commonly litigated against”.
“It further reiterates the importance of close supervision and expert training of procedures delegated by physicians.”
Study abstract unavailable.
Medscape article – Laser Hair Removal Most Litigated Energy-Based Procedure (Open access)
See more from MedicalBrief archives:
Demand for cosmetic surgery continues to grow
Botched botox and the UK’s legislative crackdown on ‘cosmetic cowboysʼ
Celebrity Brazilian plastic surgeon on the run after woman’s dealth