The report analyzes more than a decade of malpractice claims to identify trends and inform patient safety practices in plastic surgery.
The Doctors Company, a physician-owned medical malpractice insurer, released its “Plastic Surgery Claims: July Malpractice Risk Review,” a specialty-focused analysis of claims data from 2010 through 2023. The report identifies technical skill and patient communication as the primary factors leading to malpractice allegations and patient harm.
According to the findings, technical skill was a contributing factor in 77% of all plastic surgery claims and those involving high-severity injuries. Communication breakdowns contributed to 48% of claims, while patient behavior-related issues, including dissatisfaction or nonadherence, appeared in 44% of cases.
“Malpractice claims provide a powerful lens into how and why patient harm occurs,” says Julie Ritzman, senior vice president of patient safety and risk management at The Doctors Company, in a release. “By analyzing claims, we can uncover patterns that may be missed in day-to-day practice for plastic surgeons. These insights help clinicians strengthen communication, sharpen clinical decision-making, and improve care processes, while supporting safer care for every patient.”
Financial Impact and Common Allegations
The study of 1,968 closed claims found that while most cases closed without payment, 33% resulted in an indemnity payment. The average indemnity incurred for plastic surgery claims was $177,000. Among claims specifically driven by technical skill, the average payment was $168,000.
The most common negligence allegations centered on surgical technique, perioperative patient management, and patient dissatisfaction with clinical outcomes. To reduce these risks, the report suggests using checklists to standardize preoperative assessments, including patient selection, site marking, and photo documentation.
Case Study: Delayed Diagnosis Risks
The review included a case summary involving a delayed diagnosis of bowel perforation following an elective outpatient liposuction procedure that resulted in a patient death. The analysis highlighted several deficiencies, such as providing aftercare instructions only in English to a non-English-speaking patient and failing to document communication between the surgical center and the family regarding postoperative complications.
Key contributing factors in the case included the surgeon’s failure to consider a differential diagnosis for persistent nausea and vomiting. The report notes that bowel perforation by a cannula is a rare but potentially fatal complication that requires emergency surgery.
Strategies for Risk Mitigation
To increase patient safety and limit liability, the report advises plastic surgeons to prioritize patient screening and apply selection criteria to determine treatment appropriateness. It also emphasizes the importance of documentation, noting that the medical record serves as a “silent witness” to clinical decisions and patient interactions.
Recommended strategies include:
- Using the teach-back technique to confirm a patient’s understanding of possible results and align expectations.
- Providing written postoperative wound care instructions in the patient’s preferred language.
- Performing thorough follow-up to recognize and manage complications promptly.
- Recording any patient nonadherence and documenting discussions regarding the risks of continued nonadherence.
The report also suggests the use of certified healthcare or medical interpreters rather than family members to ensure medical terminology is accurately translated and to protect patient health information.
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