[Medical reviews of claims for damages and errors in urology]. / Ärztliche Begutachtung bei Vorwürfen von Behandlungsfehlern in der Urologie.

In liability law, a medical review is considered to be an expert opinion that is provided at the request of those involved (patient or physician) of a course of treatment. It must be carried out according to defined criteria with the aim of providing a plausible basis for arbitration. This is achieved by means of an objective determination of the facts, a reasonable assessment of the error(s) and (where appropriate) a realistic description of the injury involved. The following fields should be covered in a concise review: conditions and procedures applied to the review, criteria to be used in the review, types of error that are possible during the treatment, assessment of the treatment errors committed, possible treatment errors that can occur in urology, conclusions to be drawn from the review. In summary, a medical assessment carried out in the course of claims for damages should provide a balanced assessment that takes into account the confidential relationship between the physician and patient. This means that the review procedure must be performed under the best possible conditions for professional standards and care.

[Cases from the expert commission of the North Rhine medical council: expert commissions and arbitration boards by medical councils]. / Fälle aus der Gutachterkommission der Ärztekammer Nordrhein : Gutachterkommissionen und Schlichtungsstellen bei den Ärztekammern.

Following a description of the structure and function of the expert commission for medical malpractice of the North Rhine medical council, important legal technical terms and the consequences, such as the definition of accusable medical malpractice and severe (in legal terms gross) negligence will be presented. The article reports on the legal consequences of the lack of informed consent, on the significance of insufficient informed consent and under which conditions a transfer of liability becomes valid. From the statistical information in the archives of the expert commission it can be seen that in processes against urologists approximately 31% of urologists in private practice were affected compared to 69% of hospital urologists. Approximately 20% involved accusations of false diagnosis and 80% involved accusations of false treatment. Of the processes involving urological diagnostic errors prostate cancer was at the forefront, followed by processes involving delayed or falsely diagnosed bladder cancer. For processes due to operative treatment errors prostate cancer also occupied first place, followed by accusations of treatment errors involving penile and urethral operations. A differentiated presentation of processes involving non-operative treatment errors revealed an accumulation of accusations for mistakes in the treatment of urolithiasis, in medicinal treatment and also in tumor therapy. Following a description of typical individual cases, indications for avoidance of legal proceedings will be given.

[Glossary on patient safety -- a contribution to on-target-definition and to appreciate the subjects of "patient safety"]. / Das Glossar Patientensicherheit -- Ein Beitrag zur Definitionsbestimmung und zum Verständnis der Thematik "Patientensicherheit" und "Fehler in der Medizin".

Since the release of the report "To Err is Human" by the American Institute of Medicine (IOM) the subject "Medical Risks, Errors and Patient Safety" has gained increasing interest in literature. In Germany, neither extensive statistics nor generally significant epidemiological studies regarding common errors associated with damages caused to patients' health exist. In recent years the subject has become increasingly interesting both in specialist discussion and it the lay press; it has become evident that the different use of terms, especially those originating from the Anglo-Saxon language, can lead to misunderstandings. Hence, as one of the first steps of its action programme, the expert panel "Patient Safety" of the German Agency for Quality in Medicine has compiled a glossary of technical terms to provide adequate support to the discussion this important subject of nomenclature.

[Accusations of malpractice in chirotherapeutic treatment]. / Vorgeworfene Behandlungsfehler im Zusammenhang mit chirotherapeutischen Behandlungen.

BACKGROUND: Little is known about the incidence of adverse effects after chiropractic manipulation. Over representation of severe and under representation of less severe complications has to be assumed. MATERIAL AND METHODS: A total of 57 expert opinions from the malpractice advisory board of the North Rhine General Medical Council (Nordrheinische Arztekammer), as well as judgments from German courts since 1949, were analyzed. RESULTS AND CONCLUSIONS: A total of 16 of 57 cases of chiropractic manipulation (since 1975) were attested as malpractice by expert opinion, seven of which had significant negative consequences. In nine cases, the judgments of German courts refer to manual therapy. Of these, five deal with informed consent. Observance of the "Bingen Declaration" would have avoided all cases of malpractice found by the advisory board over 29 years.