Testicular torsion is overrepresented among malpractice cases for gonadal torsion

Introduction & Objective: Ovarian and testicular torsion are comparable surgical emergencies that may result in organ loss and, as such, have high litigious potential. We sought to describe the relative frequency and outcome of malpractice litigation between cases of ovarian and testicular torsion. Methods: Searches were completed in the Westlaw Jury Verdicts & Settlements and Lexis Cases databases using the following search terms: “(ovarian or ovary)/5 torsion” and “(testicular or testicle)/5 torsion”. Cases were excluded if they were not directly related to torsion or were not malpractice claims. Cases were reviewed for year, jurisdiction, age of plaintiff, verdict, appeal status, contention, damages, and alleged time delay to appropriate care. Results: The legal databases contained 155 malpractice cases related to testicular torsion and 4 cases related to ovarian torsion. Two of three ovarian torsion cases and 52% of testicular torsion cases with available rulings were in favor of the defense. The median age of plaintiffs in testicular torsion cases was 14, and 75% were minors. Median delay in care for testicular cases was 3 days, and median damages awarded to plaintiffs was $250,000 ($12,000–8.5 million). No data regarding age, delay in care, or damages were available for ovarian torsion cases. Conclusions: Among malpractice cases related to gonadal torsion, testicular torsion is vastly overrepresented despite literature demonstrating longer delays in care and greater likelihood of gonadal loss in ovarian torsion during the study period. Level of evidence: IV.