{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:07:02Z","timestamp":1781687222401,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T00:00:00Z","timestamp":1364342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The potentially severe complications resulting from cerebrospinal fluid (CSF) leak makes iatrogenic injury a medicolegal area of concern for otolaryngologists and neurosurgeons. The objectives of this analysis were to study legal outcomes as well as medical and nonmedical elements affecting malpractice litigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Public court records available in the Westlaw legal database (Thomson Reuters, New York, NY) were searched for medical malpractice litigation related to iatrogenic CSF leak. Of the 18 jury verdicts and settlements included, outcomes and awards, patient demographic data, and other factors instrumental in determining legal responsibility were recorded for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten (55.6%) cases were resolved in the defendant's favor, 2 (11.1%) resulted in damages awarded by a jury, and 6 (33.3%) were settled out of court before resolution of trial. Mean damages awarded were $1.1 million, while out of court settlements averaged $966,887. Malpractice stemming from patients who underwent endoscopic sinus surgery comprised 77.8% of cases analyzed. The most frequent alleged factors cited for litigation included having to undergo additional surgery (88.9%), developing meningitis (50.0%), and failing to recognize complications in a timely manner (44.4%). Perceived deficits in informed consent were alleged in one\u2010third of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although a slight majority of cases were resolved in the defendant's favor, payments made were considerable, averaging approximately $1 million. Strategies to decrease liability and allow patients to make more informed decisions should include clear communication with patients that explicitly states potential risks, such as meningitis, and possible need to undergo additional reparative surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21169","type":"journal-article","created":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T12:34:10Z","timestamp":1364387650000},"page":"722-725","source":"Crossref","is-referenced-by-count":52,"title":["Physician accountability in iatrogenic cerebrospinal fluid leak litigation"],"prefix":"10.1002","volume":"3","author":[{"given":"Olga","family":"Kovalerchik","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila J.","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Svider","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Mauro","sequence":"additional","affiliation":[{"name":"The University of Michigan Law School  Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soly","family":"Baredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"},{"name":"Center for Skull Base and Pituitary Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"},{"name":"Center for Skull Base and Pituitary Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"},{"name":"Department of Neurological Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"},{"name":"Center for Skull Base and Pituitary Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"},{"name":"Department of Neurological Surgery University of Medicine and Dentistry of New Jersey, New Jersey Medical School  Newark NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23285"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3080"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199609000-00015"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21089"},{"key":"e_1_2_6_6_1","first-page":"144","article-title":"Management and implications of intraoperative cerebrospinal fluid leak in transnasoseptal transsphenoidal microsurgery","volume":"68","author":"Kaptain GJ","year":"2011","journal-title":"Neurosurgery"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21040"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23766"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21092"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812437530"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.5.FOCUS1255"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2012.07.005"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2012.10.005"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811411534"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-011-0699-9"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000117225.31416.36"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000165455.20118.E3"},{"key":"e_1_2_6_18_1","volume-title":"Medical liability: impact on hospital and physician costs extends beyond insurance. 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