Endoscopic sinus surgery: A medico legal perspective

“Medical malpractice litigation issues in health care create much spark, angst& ire than anything else in the medical field.”¹ The current alleged malpractice situation in India has sparked much discussion, debate and emotion on the part of judiciary as well as clinicians.

More so, after the imbibition of recent consumer protection act 2019, newerclinicians may feel pressure, real or perceived, to order additional testing or take additional steps to document for concern of legal proceeding, adding to the gross cost of treatment. The recent judgment awarding compensation of Rs. 11 croreswere by far the biggest payout in the history of Indian medical negligence litigation².

Majority of patients who get iatrogenic injury because ofany negligence do not sue.^3,4 However, lawsuits, whether appropriate or not, are an assault on the competence,character, and integrity of the clinician.

An analytical descriptive study to find out the prime cause, financial burden, prevention & management of a lawsuit is done.

Malpractice system has an immense effect on clinician & his/her work environment & of course the society, elevating psychologic, monetary, and patient safety reasons.

Endoscopic sinus surgery (ESS), due to its location in proximity tovital structures such as orbit, optic nerve, skull base & carotid artery etc., is a procedure full of potentially calamitous issues.⁵

A pre formed check list of items, whether mental or written, before, during, and after surgery is to be checked off by every endoscopic sinus surgeon as a routine protocol. This ensures better patient care and reduced risk of litigation.

Worldwide, Sinusitis isby far the most common diagnosis involved in otolaryngology lawsuits. In USA, from 1985 to 2005, 70% of the total indemnity compensation for otolaryngology claims, were from rhinology alone.⁶