Medical Malpractice and Corticosteroid Use

Objective. To analyze malpractice litigation trends related to the administration of corticosteroids and the reported complications. Study Design. Retrospective. Setting. Tertiary medical center. Subjects and Methods. The WESTLAW database was reviewed from March 1996 to November 2008. Data were compiled on the demographics of the defendant, plaintiff, expert witness specialty, allegation, complication, indication for steroids, verdict, and judgment. Results. Eighty-three cases met inclusion criteria and were selected for review. The most common conditions for which steroids were prescribed were pain (23%), asthma or another pulmonary condition (20%), a dermatologic condition (18%), a nondermatologic autoimmune condition (17%), and allergies (6%). Allegation of negligent use was the most common reason for a suit being filed (65%), followed by lack of proper informed consent (36%), failure to diagnose or misdiagnosis (22%), multiple allegations (25%), and wrongful death (4%). Verdicts for the defendant predominated (59%), whereas 24 cases (29%) were found for the plaintiff, and 10 cases (12%) settled out of court. The range of monetary awards was from $25 000 to $8.1 million. Complications reported were often multiple and included avascular necrosis (39%), mood changes (16%), visual complaints (14%), and infectious complications (14%). Three cases involved otolaryngologists. Conclusion. Although other specialties were more often involved in suits, otolaryngologists frequently prescribe corticosteroids and must be diligent in explaining potential side effects of steroids. The informed consent process, documentation, and close monitoring of patients are critical to avoid potential litigation.