Prostate Biopsy and Malpractice: Analysis of a National Legal Database from 1995 to 2025.

[OBJECTIVE] To evaluate the current evidence on prostate biopsy litigation risks, we analyzed malpractice litigations related to prostate biopsies using a national legal database.

[METHODS] We utilized the LexisNexis Database to retrospectively analyze prostate biopsy malpractice lawsuits. We searched for keywords "prostate," "malpractice," and "biopsy" from January 1, 1995 to March 30, 2025. We focused on cases where the allegation of malpractice was specific to the biopsy, excluding cases addressing other aspects of prostate cancer care. We then reviewed case characteristics including type of biopsy, location, instigating injuries, allegations, verdict, and plaintiff award.

[RESULTS] We found 360 unique lawsuits, 24 of which met the inclusion criteria. Nine lawsuits involved transrectal prostate biopsy, while the rest were unspecified types. Out of the 47 instigating injuries named, the most common were infection (9/47), acute or chronic pain after biopsy (6/47), and erectile dysfunction (4/47), LUTS (4/47), and bleeding (4/47). Eighteen cases (75.0%) resulted in defendant verdict, while one (4%) resulted in plaintiff verdict with an award of $226,795.00. One case (4%) resulted in private settlement of unknown amount. Two lawsuits (8%) were ongoing at the time of the study, and two (8%) had undocumented verdicts.

[CONCLUSION] Despite wide utilization of prostate biopsy in the past 30 years, prostate biopsy lawsuits were rare at the federal and state court levels. Majority of the cases arose from common injuries after biopsies, and most cases resulted in the favor of the defending physicians.