Among the figures given by McLean, one number cited by him stands out by its sheer enormity. It is the number of BDIs incurred during LC, quoted at the rate of 1 injury per 200 cases. Given the large number of cholecystectomies performed annually in the United States (500 000-750 000), we should expect more than 15 000 cases of BDI in a 5-year period. McLean draws his conclusions from an analysis of only 104 cases, derived from litigation statistics. This is a very small fraction of the total case incidence. Can his observations be valid based on that small sample?
Morgenstern L. Risk Management Observations From Litigation Involving Laparoscopic Cholecystectomy—Invited Critique. Arch Surg. 2006;141(7):648. doi:10.1001/archsurg.141.7.648