Introduction: Annually the U.S. spends approximately $55.6 billion on malpractice and medical liability, with urology ranked 11th out of 25 specialties for number of malpractice claims. Our objective was to identify common causes for filing claims associated with cystectomy as well as corresponding payout outcomes. Methods: Using the Westlaw (R) legal database, a search was conducted using the keywords, "cystectomy," "cystoprostatectomy" and "bladder removal" between January 1, 1990 and January 1, 2020. Each case was evaluated for plaintiff demographics, alleged malpractice claim, defendant specialty, resulting clinical outcome, resulting legal outcome including verdict and monetary award. Alleged malpractice claims were further subdivided based on whether the claimed negligence of duty was preoperative, perioperative or postoperative. Data were analyzed using Microsoft (R) Office Excel (R). Results: After accounting for irrelevant and duplicate cases the Westlaw search returned 42 unique cases. The most common indication for cystectomy was bladder cancer (69%). Preoperative negligence resulted in the highest average payout ($2,062,204.00) and accounted for 76% of filed claims, with delay in diagnosis accounting for the most common complaint (47%). Urologists made up the highest percentage of defendants sued, at 62%. Conclusions: The bulk of alleged malpractice in cystectomy cases is due to preoperative negligence, most predominantly in the delay of cancer diagnosis. Alleged cases of preoperative negligence also return the highest award for the plaintiff. This study sheds light on areas of concern that urologists should be aware of associated with cystectomy litigation.
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