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Medical malpractice contributes to an estimated $55.6 billion in overall medical liability system costs per year. The rise of medspas has resulted in an increase in complications and litigation. In this study, we identified all publicly indexed litigation against medical spas and medical spa practitioners using the Westlaw legal database and characterized trends in these findings. A retrospective analysis of litigation against medical spas and medical providers performing care at medical spas was performed. Cases were indexed from 2006 to 2024 using the Westlaw legal database. Case documents were reviewed for the following datapoints: Patient characteristics (age, sex), legal case characteristics (state in which litigation occurred, reason for litigation, outcome, monetary payments, expert witness involvement), and medical procedure characteristics (type of procedure, location on the body in which the procedure was performed, complication, credentials of person who performed the procedure). Twenty legal cases met inclusion criteria, ranging in date from May 2006 to October 2024. The average patient age was 36 years old (SD 12.570). All plaintiffs were listed as female (n=20). 4 cases sued only the medspas, 15 sued only a medical practitioner, and in one case both the practitioner and medspa were sued. Each of the 20 cases were decided by jury decision at trial. 7 cases were won by the defendants (35%), whereas the remaining 13 cases were won by the plaintiffs. The average jury award was $2,489,128.69. Our findings highlight the importance of properly managing patient expectations and thorough discourse regarding the risks of the procedure to better align patient presurgery expectations with the final result. Our findings also emphasize the positive impact that tighter regulation of medical spas will have on patient safety. Our data is limited by the small sample size that was indexed on Westlaw legal database and descriptive in nature, so future studies analyzing larger cohorts of data may provide additional data to further benefit patient safety.

The first defense against a medical malpractice lawsuit is avoiding the lawsuit altogether. The probability of being sued can be reduced through compassion and thorough attention to the patient. A proper response to an adverse event or bad result can be crucial to avoidance of later being sued. The content of the medical and hospital chart can support a defense or, at times, can imperil the defense of the physician being sued. Aggrieved patients can pursue multiple theories of liability against an obstetrician or gynecologist.

With an increasing number of surgical procedures, particularly due to the aging population, we are facing an increase in the number of total hip arthroplasty (THA) revisions and, consequently, conflicts between surgeons and patients. There are very little data specifically dedicated to THA revisions in the international literature. Therefore, we conducted a retrospective study to identify the most common causes of lawsuits following THA revision in France. We reviewed 263 consecutive complaint files following a THA first revision between 2010 and 2023 from the Cabinet Branchet (CB) database. Collected data included: nature of the pathology leading to the revision, time between revision and complaint, American Society of Anesthestiologists (ASA) score, age and sex of patients, any complications following the revision, nature of the procedure, attribution of responsibilities, and amount of poured compensation. These 263 procedures involved 256 patients, 144 men (56.2%) and 112 women (43.7%), with an average age of 61.4 years (27-92) and an average ASA score of 2. The clinical situations leading to THA revision, that eventually resulted in a patient complaint, were: aseptic loosening (70/263, 26.6%), Surgical Site Infection (SSI, 46, 17.5%), dislocation (32, 12.2%), or implant fracture (23, 8.7%). However, in 160 cases (61%), these are the complications following the revision surgery that led to the patient's complaint. These complications were: SSI in 52.5% of cases (93/177), neurological deficit in 12.4% of cases (22/177), death (17 patients, 9.6%), persistent pain (12, 6.7%), and leg length discrepancy (LLD, 11, 6.2%). The 263 final legal proceedings were distributed as follow: 137 in French Commission for Conciliation and Compensation for Medical Accidents (CCI, 52%), 97 in judicial court (36.9%), 26 amicable settlements (9.9%), and 3 others. In 192 cases (73%), the surgeon's legal responsibility was not retained. The average compensation amount was €60,000, and >€100,000 in 6 cases (2.3%). French orthopaedic surgeons are frequently sued. CB data indicates a frequency of one implication every 27 months, excluding the field of spine surgery. Some causes of revision seem to be less well tolerated by patients than others, such as implant fractures or LLD. Nevertheless, our study shows that SSIs are the main cause of litigation, accounting for 52.9% of cases (139/263), either as the primary cause or as secondary cause following complications after first revision surgery. Aseptic loosening, surgical site infection, recurrent dislocation, and implant fractures are the primary causes of complaints leading to a lawsuit after THA revision in France. These data must be communicated to orthopaedic surgeons to better guide preoperative inform consent discussions with their patients as the quality of preoperative information is often correlated with a favourable outcome following expert advice. IV; retrospective study.

Brain diseases may determine the development of focal neurological deficits and behavioral anomalies. In some cases, behavioral alterations may lead to illicit demeanours which, in turn, may have potential serious legal consequences as well. We report the case of a male gynecologist in his seventies sued by a young female patient for sexual violence. The man had no significant premorbid medical history and was a respected medical doctor with several decades of professional activity. Months after the sexual violence episode, he began to manifest symptoms indicative of cognitive impairment, which led to a neurological examination including a Magnetic Resonance Imaging (MRI) brain scan exam. Brain MRI revealed two frontal meningiomas with mass effects and vasogenic oedema on the surrounding brain parenchyma, for which the patient underwent a neurosurgical operation. Following surgery, partial improvement in selected cognitive and behavioral domains was observed, suggesting that the frontal lesions may have contributed significantly, though not exclusively, to the clinical picture. In light of this evidence, the question arises whether and to what extent the mental capacity of the subject at the time of sexual offense could have been compromised by the presence and location of the tumors, that is, as a potential "precipitating factor" impinging on a brain with underlying neurodegenerative and/or vascular lesions.