What rhinologists and allergists should know about the medico-legal implications of corticosteroid use: A review of the literature

David M. Poetker, Timothy L. Smith

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Background: Corticosteroids are a mainstay of treatment in the management of sinonasal inflammatory disease. Despite their common use, many practitioners are not well versed in their potential complications or the medico-legal ramifications of their use. The objectives of this review were to outline the existing data of the medico-legal implications of oral steroids. Methods: An OVID database search of the terms "corticosteroids OR adrenal cortex hormones "AND "medico-legal ORmalpracticeOR jurisprudenceOR expert testimonyOR informed consent "was performed. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance. Results: TheOVID search identified 178 articles. This search was then narrowed, resulting in 9 articles thatwere relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Steroids were found to be a common medication associated with litigation and the cost of the litigation involving steroid use can be very high. Common themes associated with the litigation include poor communication and lack of informed consent regarding steroid use. Several additional articles addressed single cases and many addressed lawsuit prevention. Conclusion: Lawsuits associated with steroids are disproportionately costly and most of the allegations stem from a lack of informed consent over the use of steroids. Open dialogue with patients is the key to informed consent. Ideally, clinicians should discuss the rationale for steroid use, and the risks, expected benefits, and alternatives of the steroid therapy. Document this discussion and consider providing educational material for the patient to read and review.

Original languageEnglish (US)
Pages (from-to)95-103
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Issue number2
StatePublished - Mar 2012


  • Adrenal cortex hormones
  • Informed consent
  • Jurisprudence
  • Malpractice
  • Steroids

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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