June 25, 2024 from Medscape
Laser hair removal continues to be the most litigated energy-based procedure, according to a recent cross-sectional study examining malpractice and medical liability claims. Conducted by Dr. Scott Stratman and colleagues, the study analyzed cases involving cutaneous energy-based devices (LEBD) from 1985 to 2023, revealing key trends in legal disputes associated with these procedures.
Key Findings: Most Litigated Procedures and Providers
The study, published in the Journal of the American Academy of Dermatology, highlighted that plastic surgeons were the most frequently litigated healthcare professionals, followed by nonphysician operators (NPOs). Laser hair removal was the most common procedure involved in lawsuits, accounting for 44% of the 75 cases analyzed. Complications such as burns, scarring, and pigmentation changes were most commonly reported on the face, head, and neck.
Concerns Over Nonphysician Operators
One of the most notable findings was that 52% of the cases involved nonphysician operators performing procedures. This raises concerns about the training and supervision of these practitioners. As Dr. Stratman and his coauthors note, “The utilization of laser and energy-based devices has grown substantially,” leading to a rise in lawsuits when untrained practitioners perform procedures, sometimes with inadequate oversight. The findings underscore the need for comprehensive training and adherence to standardized protocols to mitigate risks.
Legal Outcomes and Implications
In terms of legal outcomes, 57.3% of the cases were decided in favor of the defendant, while 38.7% favored the plaintiff. There were no statistically significant differences in verdicts based on the type of operator (physician or nonphysician) or the anatomical site treated. However, the high prevalence of nonphysician operators involved in these cases highlights the need for stricter supervision and accountability when physicians delegate responsibilities.
Limitations of the Study
The study acknowledged a key limitation: the LexisNexis database used for the research did not include cases settled out of court or those that underwent third-party arbitration. This suggests that the true number of disputes involving laser hair removal may be higher than reported.
Expert Commentary: The Importance of Training and Oversight
Dr. Mathew M. Avram, an expert in laser, cosmetics, and dermatologic surgery at Massachusetts General Hospital, commented on the findings:
“This study reaffirms previous research showing that laser hair removal remains the most litigated procedure in laser surgery. It further highlights the critical importance of close supervision and expert training of procedures delegated by physicians.”
Standardized Care and Patient Safety
The takeaway from this study is clear: both physicians and nonphysician operators must be held to the same standard of care when performing energy-based procedures. As Dr. Stratman and his team conclude,
“Familiarity with malpractice trends strengthens the patient-provider relationship and equips providers with strategies to minimize legal risks.”
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