Abstract / Summary
Abstract Objective To evaluate malpractice litigation involving pituitary disease and surgery, identify patterns in alleged diagnostic, surgical, and perioperative errors, characterize legal outcomes and damages, and define the medicolegal risk of neurosurgeons involved in skull-based procedures. Methods A retrospective review of malpractice claims involving pituitary disease was conducted using WestLaw and LexisNexis legal databases. Clinical and legal characteristics collected included patient demographics, practice setting, surgical details, defendant specialty, case outcome, and monetary awards. Comparisons were performed using chi-square and nonparametric statistical tests. Results Of 389 screened cases, 87 met the inclusion criteria, with 83 known outcomes (95%). Plaintiff outcomes occurred in 34 (41%) of cases, most commonly relating to operative or post-operative injury (n = 47, 54%). Among plaintiff outcomes with a reported payout (n=, 74%), the median, 2026-adjusted award was $1,354,979 (range: $309,643-$9,767,185), with the largest unadjusted median payouts observed in pediatric cases ($3,565,000) and failure to diagnose ($990,824). No statistically significant differences in payout were observed by specialty or defendant composition, while case frequency varied by geographic region, practice setting, and surgical approach. Visual and endocrine injuries trended towards higher payouts. Conclusions Malpractice risk in pituitary disease is driven by injury severity and case complexity rather than specialty alone, with neurosurgical involvement predominating in litigation, highlighting the speciality’s central role in pituitary surgery despite the multidisciplinary nature of skull-based care. Failure to diagnose carries the highest median payouts, underscoring the need for timely evaluation and improved diagnostic pathways for pituitary disease.