Dissecting Medical Litigation: An Analysis of Canadian Legal Cases in Plastic Surgery

Introduction: Plastic surgeons are more likely to face medical litigation, compared to other specialists. Although this has been previously studied in other countries, there is a paucity of data regarding legal medical cases within Canada. The goal of this study was to compile and analyze all medical litigations in plastic surgery in Canada and identify themes associated them. Methods: A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada and WestLawNext Canada, was conducted to retrieve all legal medical cases against plastic surgeons in Canadian courts. Quantitative and qualitative analyses were performed to dissect the characteristics of plastic surgery litigation in Canada. Results: A total of 105 legal cases were included in this analysis, including 81 lawsuits and 24 appeals. The preponderance of cases was related to breast surgeries (47.0%), followed by head and neck surgeries (18.1%), with 76.5% being related to cosmetic surgery; 64.2% were ruled in favour of the surgeon. The lack of preoperative informed consent was highly associated with a final ruling in favour of the patient ( P < .0001). The average monetary value of damages awarded was $61 076. There was no significant difference in monetary value between cosmetic and reconstructive cases. Conclusion: The majority of medical litigation in plastic surgery in Canada is associated with cosmetic surgeries, most commonly of the breast. Lack of informed consent is associated with judicial rulings in favour of patients. By understanding the themes underlying these legal cases, we hope to highlight the main issues that lead to litigation in plastic surgery.

954 A Framework Recommendation for Surgeons Legal Liabilities During an Acute Health Crisis

Introduction Ethical and professional duties compelled surgeons to act outside their specialties during the SARS-CoV-2 pandemic. Our work explored the legal liabilities that have arisen for surgeons during this period. Method A literature review was conducted of medical and legal databases; PubMed, MedlineOvid, WestLaw, and LexisNexis. Statues and case law across three jurisdictions; Canada, the United Kingdom, and the Republic of Singapore were retrieved and analyzed. Results Professional regulatory bodies impose a duty to act in healthcare emergencies. Yet, formal legal protection has not been codified by either professional regulatory bodies or governments. These discrepancies between legal and professional standards leave surgeons vulnerable to litigation. Conclusions Following our analysis of cases and outcomes within these jurisdictions we propose a framework that provides basic protection to surgeons acting outside their surgical specialty, but within a general medical capacity, whilst providing care during acute health crises.

Production and distribution of child sexual abuse material by parental figures

Child sexual abuse material (CSAM) is widely available online. Existing research indicates that the parents and parental figures of victims are notably represented in offender populations. However, there is limited research in this area. Drawing on Australian media and legal databases, this study created a database of 82 cases of CSAM production and distribution perpetrated by parents and/or parental figures from 2009 to 2019. The study found that perpetrators are most often the male parental figures of the victims, and victims are predominately girls under nine years of age. The findings reveal distinct patterns and scenarios of parental CSAM offending that may inform prevention, early intervention and improved responses to victims. The study documented the significant impact of parental CSAM offending on victims and the need for specialist victim support.

The Mysterious Affair at Squire: Using Code-Breaking Games to Deliver Law Library Skills

The Squire Law Library has designed and run a series of popular escape room-style events, aimed at masters and undergraduate law students. Intended to prompt students to explore the full range of legal resources available to them, the games typically challenge participants to open a locked safe: relying on legal databases, the library catalogue and print materials to decipher a six-digit combination. This article, based on Lizz Edwards-Waller's presentation at the BIALL (virtual) conference 2020, reflects on the practicalities of running and promoting code-breaking events within the library and considers the benefits of this style of event in addition to, or instead of, more traditional law library orientation tours.

Sodium menu labelling: priorities for research and policy

Objective: To understand the different Na menu labelling approaches that have been considered by state and local policymakers in the USA and to summarise the evidence on the relationship between Na menu labelling and Na content of menu items offered by restaurants or purchased by consumers. Design: Proposed and enacted Na menu labelling laws at the state and local levels were reviewed using legal databases and an online search, and a narrative review of peer-reviewed literature was conducted on the relationship between Na menu labelling and Na content of menu items offered by restaurants or purchased by consumers. Setting: Local and state jurisdictions in the USA Participants: Not applicable. Results: Between 2000 and 2020, thirty-eight laws – eleven at the local level and twenty-seven at the state level – were proposed to require Na labelling of restaurant menu items. By 2020, eight laws were enacted requiring chain restaurants to label the Na content of menu items. Five studies were identified that evaluated the impact of Na menu labelling on Na content of menu items offered by restaurants or purchased by consumers in the USA. The studies had mixed results: two studies showed a statistically significant association between Na menu labelling and reduced Na content of menu items; three showed no effects. Conclusion: Data suggest that Na menu labelling may reduce Na in restaurant menu items, but further rigorous research evaluating Na menu labelling effects on Na content of menu items, as well as on the Na content in menu items purchased by consumers, is needed.

An analysis of malpractice litigation in the surgical management of carotid artery disease

OBJECTIVECarotid artery disease is a common illness that can pose a significant risk if left untreated. Treatment via carotid endarterectomy (CEA) or carotid artery stenting (CAS) can also lead to complications. Given the risk of adverse events related to treating, or failing to treat, carotid artery disease, this is a possible area for litigation. The aim of this review is to provide an overview of the medicolegal factors involved in treating patients suffering carotid artery disease and to compare litigation related to CEA and CAS.METHODSThree large legal databases were used to search for jury verdicts and settlements in cases related to untreated carotid artery disease, CEA, and CAS. Search terms included “endarterectomy,” “medical malpractice,” “carotid,” “stenosis,” “stenting,” “stent,” and combinations of those words. Three types of cases were considered relevant: 1) cases in which the primary allegation was negligence performing a CEA or perioperative care (CEA-related cases); 2) cases in which the primary allegation was negligence performing a CAS or perioperative care (CAS-related cases); and 3) cases in which the plaintiff alleged that a CEA or CAS should have been performed (failure-to-treat [FTT] cases).RESULTSOne hundred fifty-four CEA-related cases, 3 CAS-related cases, and 67 FTT cases were identified. Cases resulted in 133 verdicts for the defense (59%), 64 settlements (29%), and 27 plaintiff verdicts (12%). The average payout in cases that were settled outside of court was $1,097,430 and the average payout in cases that went to trial and resulted in a plaintiff verdict was $2,438,253. Common allegations included a failure to diagnose and treat carotid artery disease in a timely manner, treating with inappropriate indications, procedural error, negligent postprocedural management, and lack of informed consent. Allegations of a failure to timely treat known carotid artery disease were likely to lead to a payout (60% of cases involved a payout). Allegations of procedural error, specifically where the resultant injury was nerve injury, were relatively less likely to lead to a payout (28% of cases involved a payout).CONCLUSIONSBoth diagnosing and treating carotid artery disease has serious medicolegal implications and risks. In cases resulting in a plaintiff verdict, the payouts were significantly higher than cases resolved outside the courtroom. Knowledge of common allegations in diagnosing and treating carotid artery disease as well as performing CEA and CAS may benefit neurosurgeons. The lack of CAS-related litigation suggests these procedures may entail a lower risk of litigation compared to CEA, even accounting for the difference in the frequency of both procedures.

Challenges Associated with Utilization of Legal Information Resources by Postgraduate Law Students in Federal Universities of Northern Nigeria

The paper investigates the challenges associated with utilization of legal information resources in the faculty of law libraries in federal universities of northern Nigeria. The study employed quantitative research method using cross-sectional survey research design. The population of the study comprised of 1,348 postgraduate law students in the libraries studied. Simple random sampling equation (SRS-Equation) was used to select the sample size for the study. A total of 308 postgraduate law students was therefore the sample size chosen for the study. A self-developed questionnaire was used to collect data. A total number of 308 copies of questionnaire were administered personally by the author and 4 research assistants, out of which 271 were returned and found useful for further analysis. Data collected was analyzed using descriptive statistics with the aid of SPSS (v21). Findings revealed that, the printed legal information resources were highly utilized by postgraduate law students except e-resources and on-line legal databases that had low utilization. Some challenges associated with the utilization of legal resources were insufficient copies of books, inadequate reading facilities and defaced information resources; inadequate infrastructure for accessing resources electronically, insufficient computers and interrupted power supply, among others. The study concludes that, despite the technological advancement and globalization the world is experiencing, postgraduate law students in federal universities of northern Nigeria are yet to fully enjoy the vast electronic legal information resources, and this could significantly affect the quality of legal researches and academic excellence in legal profession. The study recommends among other things the need for the provision of adequate electronic legal information resources and regular subscription to online legal databases in the faculty of law libraries in federal universities in northern Nigeria. Keywords: Utilization, Legal Information Resources, Postgraduates, Law students, Libraries

Editor’s Corner

To continue the legal theme set by the cover photo contest, I am often called on by colleagues to teach strategies for finding legal resources in library instruction sessions. Legal databases and legal materials are often perceived as foreign and overwhelming to undergraduate students as compared to other scholarly resources. Teaching legal materials also often includes having to give a brief overview of the legal system so students understand what types of materials are available to them. When demonstrating how to find legal materials I demonstrate case law relevant to the curriculum in the class, but I find that an active learning session helps reengage the students who are needing a break. I have a collection of “fun laws” for students to find and briefly read so that I know they have learned basic searching techniques. I break down these session to search for case law by citation and by case names.