While it is often assumed that supervising surgeons are liable for all negligent acts that occur in the operating room, a new study published in JAMA Surgery finds that surgical residents are not immune from malpractice litigation.

Using the Westlaw database, researchers examined 87 malpractice cases involving surgical trainees that occurred over a 10-year period.  Median patient age was 44.5 years and 67 cases (77%) resulted in death or permanent disability. Most cases (70%) involved elective procedures, and general surgery was the most common specialty involved. A junior resident was named as a defendant in 69% of cases, while lack of direct supervision by the attending physicians was cited in 55% of cases.

Cases most often involved questions regarding perioperative medical knowledge, decision-making errors, and injuries. Junior residents were most likely to be involved in lawsuits relative to medical decision-making — in 87% of cases a junior resident was the defendant. Although only 48% of cases resulted in a jury verdict or settlement in favor of the plaintiff, the median award was $900,000, with a range of $1852 to $32 million.

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These findings underscore the importance of appropriate supervision by attending physicians and the need for education in this area to reduce litigation. Surgical training programs need to develop more effective methods of faculty supervision and improve communication between residents and attending physicians.

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Even though many cases are decided in favor of the physician, litigation can exact an emotional toll on defendants and contribute to physician burnout. ”Preventing medical malpractice lawsuits involving trainees benefits the healthcare system, and most importantly, the patient,” the researchers concluded.


Thiels CA, Choudhry AJ, Ray-Zack MD, et al. Medical malpractice lawsuits involving surgical residents [published online August 30, 2017]. JAMA Surg. doi:10.1001/jamasurg.2017.2979