Complications after lumbar discectomies: A medicolegal perspective from Turkey

Abstract

Lumbar discectomy is the most commonly encountered cause of lawsuits among medicolegal cases in Turkey. The evaluation of medical malpractice in Turkey has been carried out by the Supreme Council of Health under the Ministry of Health and the Institute of Forensic Medicine under the Ministry of Justice, which are all accepted as medical experts by courts of law. This study includes medicolegal review of 14 patients who had undergone discectomy during the period of 1998 to 2005 and who have been investigated and reported by the Third Special Board comprising medical experts for medical malpractices in the Institute of Forensic Medicine. Six patients had intra-abdominal large vessel injury, 6 had postoperative discitis, and 2 had wrong space intervention. The Special Board decided that the practice in 8 of the 14 cases was not within the range of medically permitted risk, and the neurosurgeon was negligent while no negligence was found to have occurred in 6 cases. The conclusion of this review was that it is important that a neurosurgeon should tell the patient that a life-threatening complication may ensue after lumbar discectomy and should fully inform the patients or the next of kin about the complications of such surgery. In case of a medical malpractice event, which is not included in the medically accepted risks by the majority of neurosurgeons, it is inevitable that the surgeon will be found negligent in the Turkish system despite the presence of an informed consent.