Delayed Diagnosis Of Joint Replacement Infections Often Lead To Medical Malpractice Claims: Study

According to French researchers, delayed infection diagnosis following hip and knee replacements is a leading cause of medical malpractice claims, indicating that early consultation with an infectious disease specialist may help avoid litigation.

In a study published last month in the medical journal The Journal of Bone and Joint Surgery, researchers retrospectively analyzed data involving periprosthetic joint infections from 2010 to 2014, which suggest that late diagnosis appears to be a major cause of inappropriate management and medical malpractice claims.

Joint replacement infections do not occur often, but are the leading cause of malpractice litigation, according to the researchers. While the basis for the underlying claims was not known, data suggests that the issues were often linked to how long it takes for the infection to be diagnosed following joint replacement surgery.

According to the researchers, it was when healthcare professionals deviated from these guidelines, delaying infection diagnosis and treatment, that litigation occurred.

Researchers looked at a total of 45 claims for joint infections, finding that 21 patients underwent knee arthroplasty and 21 underwent hip arthroplasty. The group also included two shoulder cases and one case of ankle joint replacement.

The study determined that “discordances with therapeutic guidelines” occurred in 76% of patient files where litigation was involved. Of those cases, 44% involved delayed diagnosis, 18% involved inadequate medical treatment, and 13% involved medico-surgical treatment.

The researchers indicate that earlier consultation with an infection disease specialist could reduce the number of medical malpractice claims filed for delayed diagnosis.

In the United States, a 2015 study by the Centers for Medicare and Medicaid Services (CMS) found that major joint replacement and severe infections were the top two most costly healthcare concerns. Those researchers looked at the top diagnostic related groups based on discharges, costs, and service utilization, examining hospital data on the 100 most common Medicare inpatient stays and 30 outpatient procedures conducted by 3,000 hospitals in all 50 states and the District of Columbia.

In recent years, problems have developed with a number of hip and knee replacement systems, which were linked to higher-than-expected failure rates, often due to design or manufacturing defects. Probably the most problematic have been metal-on-metal hip replacements sold by a number of different manufacturers, which featured a metal femoral head that rotates within a metal acetabular cup.