Reducing the Risks Associated with Burn Injuries

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Burn injuries account for 18% of medical malpractice claims among plastic surgeons insured by MagMutual. The applications of lasers in medicine continue to advance with the addition of new devices and the expansion of indications for laser therapy, however surgeons need to be aware of the liability risks associated with complications such as burns.

To help plastic surgeons reduce the occurrence of claims related to burn injuries, MagMutual’s medical faculty and risk consultants have analyzed our claims data, determined the main causes of claims related to this injury and developed strategies to improve patient outcomes.

Top Risks

Top Strategies for Reduction

Based on these top risk drivers, implementing the following clinical and operational strategies can help you prevent unexpected outcomes and increase defensibility of a medical malpractice claim:

Clinical strategies

• Maintain awareness of the operative field, utilize the minimum power intensity necessary, shield surrounding areas, safely holster laser/cautery device when not in use, and ensure that alarm systems are active throughout the procedure.
• Use a test-spot during a consultation visit to assess for complications. Pay close attention to skin response, and reduce settings or do not re-treat areas of possible concern.
• Maintain control of the laser/bovie tip to ensure appropriate depth and location to prevent injury. Require immediate physician notification in case of burn or skin concern. 

Operational strategies

• Document informed consent discussion, including risk of burns. Document skin response to treatment throughout the procedure. Consider obtaining pre- and post-treatment photos of procedure site for the medical record. If injury occurs, provide and document wound care instructions and consideration for wound care center referral.
• Provide appropriate oversight of any non-physician performing lasers or other advanced technological devices. Ensure physicians and non-physicians are adequately trained for any devices that offer potential for burn injury. These procedures are paid out-of-pocket, and customer service is important. These procedures are often done on Fridays so that the patient can recover over the weekend, but complications typically arise within the first 48 hours, when the office is closed. It is important to have contact information in the event that these complications occur.
• For any personnel operating the medical equipment, make sure to familiarize yourself with manufacturer recommended settings and if plans are to exceed them, then document appropriate reasoning.

Other Top Risks

While burn injuries account for a significant number of claims among plastic surgeons according to our data, we’ve identified several other drivers of loss based on claims frequency:

Risk Drivers by Top Cause

Risk Drivers by Frequency

Data Collection & Methodology

Data is based on MagMutual closed claims from 2011-2021 and corresponding exposure data. Clinical and non-clinical loss drivers are based on an in-depth review of each claim by a medical professional or clinical risk consultant. Risk reduction strategies are based on input from practicing physicians.