RESUMEN
Objective: Medicolegal examination of an intervention as common as endotracheal intubation may be valuable to physicians in many specialties. Our objectives were to comprehensively detail the factors raised in litigation to better educate physicians on strategies for minimizing liability and augmenting patient safety. Methods: Publicly available court records were searched for pertinent litigation. Ultimately, 214 jury verdict and settlement reports were examined for various factors, including outcome, award, geographic location, defendant specialty, setting in which an injury occurred, patient demographics, and other causes of malpractice. Results: Ninety-two cases (43.0%) were resolved in the defendant's favor, with the remaining cases resulting in out-of-court settlement or a plaintiff's verdict. Payments from these cases were considerable, averaging $2.5 M. The most frequent physician defendants were anesthesiologists (59.8%) and emergency-physicians (19.2%), although other specialties were well represented. The most common setting of injury was the operating room (45.3%). Common factors included sustaining permanent deficits (89.2%), death (50.5%), and anoxic brain injury (37.4%). Injuries occurring in labor and delivery mostly involved newborns and had among the highest awards. Conclusions: Litigation involves injuries sustained in numerous settings. The most common factors present included sustaining permanent deficits, including anoxic brain injury. The presence of this latter injury increased the likelihood of a case being resolved with payment. Finally, deficits in informed consent were noted in numerous cases, stressing the importance of a clear process in which the physician explains specific risks (such as those detailed in this analysis), benefits, and alternatives.
RESUMEN
Background: The need for greater emphasis on research contributions in academic anesthesiology has been widely recognized in recent years. Some propose increasing integration of research, including dedicated research time, into ACGME requirements for residency and fellowship training experiences. The h-index, an effective measure of research productivity that takes into account relevance and impact of an author's contributions on discourse within a field, was used to examine whether there are differences in research productivity between non-fellowship and fellowship-trained faculty in academic anesthesiology departments. This bibliometric was further used to examine differences in subspecialties, and other specialties of medicine. Methods: Research productivity, as measured by the h-index, was examined using the Scopus database for 508 academic Anesthesiologists practicing in the various subspecialties. Results: There was no statistical difference in research productivity, as measured by the h-index, between non-fellowship and fellowship-trained academic anesthesiologists (2.98+-0.32 vs. 2.88+-0.31). Critical care anesthesiologists had the highest h-indices (5.78+-1.11), while regional anesthesia and pain medicine practitioners had the lowest values (1.18+-0.32). Unlike in anesthesiology, a sample of physicians from other specialties revealed a statistical difference in h-index between non-fellowship and fellowship-trained physicians. Conclusions: Scholarly productivity, as measured by the h-index was similar for fellowship and non-fellowship trained anesthesiologists.
RESUMEN
The purpose of this study is to determine if anatomy cadavers fixed in a formalin solution are a possible source of introduction of microorganisms into the anatomy laboratory. Routinely preserved cadavers were sampled for microbiological contaminates prior to examination and dissection by anatomy students. Regions sampled include the axilla, oral/nasal cavity, and inguinal/perineal region. Using conventional bacteriologic culture and identification methods our research group was able to successfully recover and identify a variety of organisms from all cadavers and in all regions tested. The results indicate that cadavers processed with 10% buffered formalin have viable organisms on their surfaces that can be a source of contamination of laboratory equipment and clothing. Given the diversity of bacterial species cultured, preserved cadavers used for anatomy education as well as research must be considered a possible source for dissemination of bacterial organisms. This study underscores the importance of standard infection control protocols.
