Objective  To identify and analyze all medical injury liability disputes lawsuits pertaining to inferior vena cava filters (IVCF) in “Lexis^®China” database, the causes and outcomes of litigation of the cases were clarified with a view, and to provide suggestions for preventing potential medical patient dispute lawsuits and improving the clinical diagnosis and treatment level of doctors. Method  The term “inferior vena cava filter” was searched in Lexis^®China, and spanning from 2011-01-01 to 2022-12-31. Results  A total of 221 cases of medical injury liability disputes were found, after screening and exclusion, a total of 179 relevant cases were included in this study for analysis. All first instance lawsuits were brought by patients against hospitals and had a high rate of compensation awarded (91.6%). Forty four cases were entered second instance litigation, and the proportion of maintaining the original judgment was high (68.2%). The main content involving the modification of the judgment was to increase the compensation amount (85.7%). In the 14 lawsuits related to the failure to place IVCF by the medical authority, the litigation points were all disputes arising from the hospital’s improper diagnosis and treatment of VTE patients, which led to the failure to place IVCF, with the highest proportion (92.3%) of improper diagnosis and treatment of pulmonary embolism (PE). For PE and deep vein thrombosis patients with clear indications for IVCF implantation but not placed, leading to litigation, the hospital bore different liability for compensation (18%–100%) depending on the fault factors of the hospital’s negligence in diagnosis and treatment. The hospital could also be held responsible for inadequate informed disclosure to affect patient judgment (23.1%). In 165 lawsuits related to the placement of IVCF, the vast majority of IVCF implants were for the diagnosis and treatment of VTE in patients (73.9%). However, such unplanned operations caused additional injuries and expenses to patients, and VTE occurred most frequently during hospitalization (76.2%). This type of embolism was most commonly secondary to fracture incision and fixation surgery (31.2%), and the average liability of hospitals for compensation varied due to different secondary factors. The occurrence of intraoperative and postoperative complications related to IVCF implantation could also lead to litigation (18.8%), and the proportion of dead patients in litigation was relatively high (32.3%). The most common complication leading to litigation was PE recurrence or exacerbation (22.5%), while intraoperative complications were vascular injury during interventional procedures (2/3). The overall trend of IVCF-related lawsuits reserves between 2011 and 2020 showed an overall upward trend, reaching a peak of 37 cases in 2020; the average amount of damages exceeded 100 000 yuan per case in 10 of the 12 years included in the statistics. Conclusions  In China’s IVCF-related medical liability lawsuits, patients most often sue their doctors, who are often sued for failure to insert a filter due to untimely diagnosis and treatment of VTE, inadequate notification of informed consent for IVCF insertion, unplanned IVCF insertion due to the presence of VTE and IVCF-related complications, and the outcome is often unfavourable to the doctors. In addition, the number of IVCF related lawsuits and hospital compensation amounts have remained high in recent years.

Citation： LIAO jianyu, WU Zhoupeng, ZHAO Jichun. Analysis of litigation cases of medical injury liability disputes related to inferior vena cava filters. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(5): 569-574. doi: 10.7507/1007-9424.202302025 Copy