Characterization of Orthopaedic Surgeon Expert Witnesses in Pediatric Orthopaedic Malpractice Litigation: A Multi-Decade Analysis

Background Expert witness (EW) testimony is central to malpractice adjudication. Pediatric orthopaedics presents unique medicolegal considerations yet EW characteristics in this domain remain poorly defined. This study aimed to characterize orthopaedic surgeon EWs in publicly available pediatric orthopaedic medical malpractice cases.Methods A national legal database was queried for orthopaedic EWs testifying in pediatric orthopaedic malpractice cases from 1980 to 2024. An internet search and Scopus database query was conducted for each orthopaedic EW, to collect party retention (plaintiff vs defendant), fellowship training, years in practice, practice setting, Hirsch index (h-index), and public advertisement of EW services.Results A total of 47 of 3,093 records screened met inclusion criteria. These cases involved 83 orthopaedic surgeon EWs providing 92 testimonies. Of these, 43 (51.8%) EWs were pediatric fellowship trained, accounting for 52/92 (56.5%) testimonies. Pediatric-trained EWs were more often academically affiliated (76.7% vs 40.0%, P P = .079). No additional statistically significant differences were detected between the plaintiff and defense-retained or pediatric and nonpediatric-trained EWs (P > .05).Conclusions Orthopaedic EWs involved in pediatric malpractice cases were frequently fellowship trained, academically affiliated, and demonstrated substantial scholarly activity. Pediatric fellowship-trained EWs accounted for over half of total EWs. No significant differences between plaintiff and defense-retained EWs were identified across measured characteristics.Key concepts (1)Over half of all orthopaedic experts were pediatric fellowship trained.(2)Plaintiff and defense-retained expert witness did not differ significantly.(3)Presence of a pediatric-trained expert was not associated with case outcome.Level of evidence III, Retrospective cohort study.