AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 t...AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso- phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.展开更多
AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of c...AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. RESULTS: There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequen-cies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374 794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70 730 101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. CONCLUSION: There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation.展开更多
Veterinarians today face an increased risk for malpractice claims in view of increased client awareness of the benefits of the human-animal bond and advances in preventive and specialized veterinary medicine.An import...Veterinarians today face an increased risk for malpractice claims in view of increased client awareness of the benefits of the human-animal bond and advances in preventive and specialized veterinary medicine.An important problem with medical malpractice litigation is the manner in which malpractice claims are resolved. In several countries, thousands of claims have been successfully resolved via Alternative Dispute Resolution processes such as mediation, conciliation and arbitration.In medical media-tion, health care providers, patients/animal owners, families, clergy and attorneys partici-pate directly in an informal, usually voluntary, dispute resolution process that can lead to for unique and promising approaches to resolving conflicts.Recently in Italy framework legislation addressing mediation has been introduced and it is also used to resolve medical malpractice disputes.Given that in Italy medical mediation is formally a new concept and is still evolving, an examination is made. The importance of “mediation” for veterinarians’ civil liability will be evaluated, underlining how it could become an important instrument in speeding up the resolution of court actions concerning medical mal-practice.展开更多
Background: So far, five types of prevention including: primordial, primary, secondary, tertiary and quaternary prevention levels have been defined in literatures. Aim: In this study, we have proposed “prevention of ...Background: So far, five types of prevention including: primordial, primary, secondary, tertiary and quaternary prevention levels have been defined in literatures. Aim: In this study, we have proposed “prevention of malpractice” as the other level of prevention. Methods: Qualitative comparison of the data, obtained from the review of conducted studies by using of scientific literatures, registered in PubMed, Google Scholar and Scopus sites. Results: Bringing dozens of examples of “malpractice” in the five areas of prevention. Conclusion: We concluded that, “malpractice” may be occurred at all levels of prevention and preventing it can be considered as the other level of prevention.展开更多
BACKGROUND Errors,misdiagnoses,and complications can occur while trainees are involved in patient care.Analysis of such events could reveal areas for improvement by residency and fellowship programs.AIM To examine law...BACKGROUND Errors,misdiagnoses,and complications can occur while trainees are involved in patient care.Analysis of such events could reveal areas for improvement by residency and fellowship programs.AIM To examine lawsuits tried at the state and federal level involving otolaryngology trainees.METHODS The LexisNexis database,an online legal research database containing state and federal case records from across the United States,was retrospectively reviewed for malpractice cases involving otolaryngology residents or fellows from January 1,1990 to December 31,2020.Case data collected:Plaintiff/trainee/defendant characteristics,allegations,medical outcomes,and legal outcomes.RESULTS Over the study period,20 malpractice lawsuits involving otolaryngology trainees were identified.Plaintiffs raised numerous allegations including procedural error(n=12,25.5%),incorrect diagnosis and/or treatment(n=8,17.0%),and lack of knowledge of trainee involvement(n=6,12.8%).Nine cases(45%)had verdicts in favor of the plaintiff,whereas 5 cases(25%)had verdicts in favor of the defense.Six cases(30%)ended in a settlement.Awards to plaintiffs were heterogenous,with a median of$617,500(range$32K-17M)for settled cases and verdicts favoring plaintiffs.CONCLUSION The findings enclosed herein represent the first published analysis of trainee involvement in otolaryngology malpractice cases held at the state/federal level.Otolaryngology trainees can be involved in lawsuits for both procedural and nonprocedural events.This study highlights the importance of education specifically in the domains of procedural errors,informed consent,proper diagnosis/management,and clear communication within patient care teams.Training programs should incorporate these study findings into effective simulation courses and didactic sessions.Educating trainees about common pitfalls holds the promise of decreasing healthcare systems costs,reducing trainee burnout,and,most importantly,benefiting patients.展开更多
At the beginning of the 1970s,the United States turned onto the winding road of medical malpractice compensation.With the goal of properly dealing with this issue,the United States embarked on a process of continuous ...At the beginning of the 1970s,the United States turned onto the winding road of medical malpractice compensation.With the goal of properly dealing with this issue,the United States embarked on a process of continuous reform.In recent years,the number of disputes over medical malpractice liabilities in China has increased considerably.However,dealing with these disputes in accordance with the provisions of the current law is not going smoothly,and maybe we can learn from the experiences of the United States.The relevant measures for the solutions to medical malpractice in the United States and China will be analyzed from a comparative perspective.These include enactments of medical malpractice,the classification of medical malpractice,the doctrine of liability fixation,the burden of proof,the criterion of judging negligence,the liability subject,the authentication system,expert witnesses,standards of compensation,and suggested reforms in the system of the medical malpractice liability,including stipulating the medical malpractice liability of administration in the Civil Code,optimizing the criteria of recognizing negligence,applying organizational fault liability,establishing pilot projects of no-fault medical liability,developing an open mechanism for medical malpractice disclosures and improving the capacity to deal with medical chaos.展开更多
文摘AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso- phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.
文摘AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. RESULTS: There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequen-cies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374 794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70 730 101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. CONCLUSION: There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation.
文摘Veterinarians today face an increased risk for malpractice claims in view of increased client awareness of the benefits of the human-animal bond and advances in preventive and specialized veterinary medicine.An important problem with medical malpractice litigation is the manner in which malpractice claims are resolved. In several countries, thousands of claims have been successfully resolved via Alternative Dispute Resolution processes such as mediation, conciliation and arbitration.In medical media-tion, health care providers, patients/animal owners, families, clergy and attorneys partici-pate directly in an informal, usually voluntary, dispute resolution process that can lead to for unique and promising approaches to resolving conflicts.Recently in Italy framework legislation addressing mediation has been introduced and it is also used to resolve medical malpractice disputes.Given that in Italy medical mediation is formally a new concept and is still evolving, an examination is made. The importance of “mediation” for veterinarians’ civil liability will be evaluated, underlining how it could become an important instrument in speeding up the resolution of court actions concerning medical mal-practice.
文摘Background: So far, five types of prevention including: primordial, primary, secondary, tertiary and quaternary prevention levels have been defined in literatures. Aim: In this study, we have proposed “prevention of malpractice” as the other level of prevention. Methods: Qualitative comparison of the data, obtained from the review of conducted studies by using of scientific literatures, registered in PubMed, Google Scholar and Scopus sites. Results: Bringing dozens of examples of “malpractice” in the five areas of prevention. Conclusion: We concluded that, “malpractice” may be occurred at all levels of prevention and preventing it can be considered as the other level of prevention.
文摘BACKGROUND Errors,misdiagnoses,and complications can occur while trainees are involved in patient care.Analysis of such events could reveal areas for improvement by residency and fellowship programs.AIM To examine lawsuits tried at the state and federal level involving otolaryngology trainees.METHODS The LexisNexis database,an online legal research database containing state and federal case records from across the United States,was retrospectively reviewed for malpractice cases involving otolaryngology residents or fellows from January 1,1990 to December 31,2020.Case data collected:Plaintiff/trainee/defendant characteristics,allegations,medical outcomes,and legal outcomes.RESULTS Over the study period,20 malpractice lawsuits involving otolaryngology trainees were identified.Plaintiffs raised numerous allegations including procedural error(n=12,25.5%),incorrect diagnosis and/or treatment(n=8,17.0%),and lack of knowledge of trainee involvement(n=6,12.8%).Nine cases(45%)had verdicts in favor of the plaintiff,whereas 5 cases(25%)had verdicts in favor of the defense.Six cases(30%)ended in a settlement.Awards to plaintiffs were heterogenous,with a median of$617,500(range$32K-17M)for settled cases and verdicts favoring plaintiffs.CONCLUSION The findings enclosed herein represent the first published analysis of trainee involvement in otolaryngology malpractice cases held at the state/federal level.Otolaryngology trainees can be involved in lawsuits for both procedural and nonprocedural events.This study highlights the importance of education specifically in the domains of procedural errors,informed consent,proper diagnosis/management,and clear communication within patient care teams.Training programs should incorporate these study findings into effective simulation courses and didactic sessions.Educating trainees about common pitfalls holds the promise of decreasing healthcare systems costs,reducing trainee burnout,and,most importantly,benefiting patients.
基金This article is the phased achievement of the key project of the Key Research Base of the Humanities and Social Sciences of the Ministry of Education:“Research on the Reform of China Tort Liability Law”(16JJD820015).
文摘At the beginning of the 1970s,the United States turned onto the winding road of medical malpractice compensation.With the goal of properly dealing with this issue,the United States embarked on a process of continuous reform.In recent years,the number of disputes over medical malpractice liabilities in China has increased considerably.However,dealing with these disputes in accordance with the provisions of the current law is not going smoothly,and maybe we can learn from the experiences of the United States.The relevant measures for the solutions to medical malpractice in the United States and China will be analyzed from a comparative perspective.These include enactments of medical malpractice,the classification of medical malpractice,the doctrine of liability fixation,the burden of proof,the criterion of judging negligence,the liability subject,the authentication system,expert witnesses,standards of compensation,and suggested reforms in the system of the medical malpractice liability,including stipulating the medical malpractice liability of administration in the Civil Code,optimizing the criteria of recognizing negligence,applying organizational fault liability,establishing pilot projects of no-fault medical liability,developing an open mechanism for medical malpractice disclosures and improving the capacity to deal with medical chaos.
