A case series of medical disputes related to chronic pain management in South Korea between 2009 and 2019: An analysis of the Korean Society of Anesthesiologists database

As interventional pain management has been growing rapidly worldwide and chronic pain management is provided by a diverse range of practitioners, malpractice litigation has increased. Therefore, we examined the characteristics of medical disputes related to chronic pain management from 2009 to 2019 in South Korea. In this retrospective study, we analyzed the Korean Society of Anesthesiologists database covering case files from July 2009 to June 2019. We compared characteristics of patients, treatment details, mechanisms of injury, specific complications, clinical manifestations of injury, and outcomes between the first half (2009–2014, n = 33) and the second half (2014–2019, n = 65) of the study period using the Korean Society of Anesthesiologists Legislation Committee database. During the 10-year study period, the proportion of cases for chronic pain management in cases referred for surgical anesthesia or chronic pain management increased annually by 2.9% (R(2) = 0.489, 95% confidence interval: 0.5%–5.2%, P = .024). While invasive procedure-related cases decreased from 63.6% in the first half to 38.5% in the second half (P = .019), complex regional pain syndrome-associated cases increased from 30.3% (10/33) to 55.4% (36/65) during this period (P = .019). The proportion of cases involving non-anesthesiologists in invasive procedure-related cases increased from 14.3% in the first half to 64.0% in the second half (P = .002). The majority of invasive procedure-related cases (82.6%, 38/46) were determined as ‘directly related to the procedure’. Of these, the 3 most common damaging events were bleeding, intrathecal injection of local anesthetics, and infectious complications (each n = 6). During a recent decade, there were several typical changes in the characteristics of medical dispute cases related to chronic pain management, including an increasing trend of cases for chronic pain management relative to surgical anesthesia-related cases, a higher severity of complications in cervical procedures, an increase in complex regional pain syndrome-related cases, and an increase in cases involving non-anesthesiologists.