Why do surgeons get sued after performing amputations? An analysis of malpractice litigation from 1983 to 2024

Limb amputations represent a life-altering medical intervention and can lead to litigation for surgeons. The study aims to identify factors associated with outcomes favoring plaintiffs in malpractice claims concerning limb amputation. The Westlaw database was queried for malpractice claims related to amputations resulting in verdicts or settlements. 547 cases in the United States from 1983 to 2024 that listed a surgeon as a defendant were included. Factors associated with plaintiff rulings were identified with multivariate analyses. 64 (12%) were upper extremity amputations, 480 (88%) lower extremity, and 3 (1%) involved multiple limbs. The two most common reasons for amputation were infection (164, 30 %) and limb ischemia (154, 28%). 228 cases (42%) resulted in a plaintiff ruling; average indemnity payment was $2.3+/−$3.8 million . Defendants were most often orthopedic surgeons (238, 44%). Amputations caused by infection or vascular disease were more likely to result in a plaintiff ruling (P = 0.04, P = 0.054). Litigation alleging improper postoperative management or surgical error were more likely to result in a defendant ruling (P = 0.01, P < 0.001). Malpractice claims regarding amputation have high financial burden but most often result in a defendant verdict, without significant variation by site or surgeon specialty. Retrospective cohort, Level III.