Lessons learned: A review of Canadian appendectomy malpractice litigation cases and regulatory complaints

BACKGROUND: Review of medical malpractice case law and health professions review and appeals board (HPRAAB) decisions related to appendectomy cases can help inform risk mitigation strategies in perioperative management and improve patient outcomes and surgical practice. METHODS: This retrospective study was performed using decisions published in the publicly accessible Canadian Legal Information Institute database (CanLii). Descriptive statistics were recorded and presented as number and percentage for categorical data. RESULTS: The search identified 299 cases, 15 of which (including 3 HPRAAB decisions) met study criteria spanning 1986 to 2024. Allegations of malpractice were most commonly related to diagnostic error including both misdiagnosis and delayed diagnosis (n = 6/15, 40.0%), inadequate monitoring or follow-up (n = 4/15, 26.7%), poor decision-making in complicated post operative courses (n = 2/15, 13.3%), inadequate documentation (n = 2/15, 13.3%), and incorrect organ removal (n = 1/15, 6.7%). CONCLUSIONS: Analysis of case law and HPRAAB decisions involving allegations of malpractice in the performance of appendectomies has yielded valuable insight into multiple areas of improvement for patient care.