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1.
Plast Reconstr Surg ; 146(4): 430e-438e, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32590525

RESUMO

BACKGROUND: Although hand surgery is generally safe and effective, some patients experience complications or poor outcomes prompting them to seek compensation. This study reviews malpractice claims in hand surgery using a national data set to assess reasons for litigation and identify predictors of outcome. METHODS: The Westlaw database was queried for cases related to hand surgery and medical malpractice between 1989 and 2018. Jury verdicts and settlements were reviewed for relevance, and variables including plaintiff and defendant demographics, diagnosis, alleged reason for malpractice, verdicts, and payouts were recorded. RESULTS: Four hundred thirty relevant claims were identified. Distal radius fractures (21 percent), carpal tunnel syndrome (14 percent), and tendon lacerations (6 percent) were the most common diagnoses. Alleged reasons for malpractice included failure to diagnose/treat (34 percent), surgical negligence (29 percent), and improper procedure/treatment (19 percent). Thirty-six cases (8 percent) resolved in settlement for a mean payout of $551,957. A plaintiff verdict was reached in 98 cases (25 percent of trials), with a mean payout of $832,258. The remaining 296 cases (75 percent of trials) resulted in defendant verdicts (no payout). Plaintiff age, plaintiff sex, defendant sex, and defendant degree had no impact on trial outcome. Cases involving surgeons without subspecialty certification in hand surgery were significantly more likely to result in plaintiff verdicts (27 percent versus 7 percent with hand subspecialization; p = 0.003). CONCLUSIONS: This study reviews malpractice claims in hand surgery over the past 30 years. Providing timely diagnoses, managing expectations, and reducing procedural error may decrease the risk of litigation.


Assuntos
Mãos/cirurgia , Imperícia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Especialidades Cirúrgicas/legislação & jurisprudência , Humanos , Fatores de Tempo , Estados Unidos
2.
J Pediatr Surg ; 54(5): 891-894, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30782439

RESUMO

The following is a summary of the fourth Ein Panel Debate Session from the 50th Annual Meeting of the Canadian Association of Pediatric Surgeons (CAPS) held in Toronto, ON, from September 26-29, 2018. The session focused on surgeon well-being at different stages of career: role of mentorship at the start of career, second victim syndrome, litigation stress syndrome, and retirement. Using Maslach Burnout Inventory Survey, CAPS members were presented their wellness scores as a group compared to other health care providers. The power of surgical culture in influencing decision making and judgment was explored. A culture shift toward vulnerability and transparency is possible and more suitable to expert practice and surgeon wellness.


Assuntos
Esgotamento Profissional/etiologia , Pediatria , Sociedades Médicas , Especialidades Cirúrgicas , Cirurgiões/psicologia , Canadá , Humanos , Tutoria , Pediatria/educação , Pediatria/legislação & jurisprudência , Escalas de Graduação Psiquiátrica , Aposentadoria , Especialidades Cirúrgicas/educação , Especialidades Cirúrgicas/legislação & jurisprudência , Cirurgiões/legislação & jurisprudência , Inquéritos e Questionários
4.
Surgeon ; 16(1): 27-35, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27161098

RESUMO

INTRODUCTION: Medico-legal claims are a drain on NHS resources and promote defencive practice. The litigious burden of surgery in England has not been previously described. This paper describes trends over ten years of claims made against the NHS across 11 surgical specialities. MATERIALS AND METHODS: Data were requested for all claims received by the NHS Litigation Authority (NHSLA) from 2004 to 2014. Surgical specialities included cardiothoracic, general, neurosurgery, obstetric, oral and maxillofacial (OMFS), orthopaedic, otorhinolaryngology, paediatric, plastic, urology and vascular surgery. A literature review of peer-reviewed publications was performed with search terms 'NHSLA' and 'Surgery'. RESULTS: The NHS paid out approximately £1.5 billion across 11 surgical specialities from 2004 to 2014. Orthopaedic, obstetric and general surgery received the largest number of claims per year, and paediatric surgery the least. The mean time from registration of claim with the NHSLA to settlement was 25.5 months (range 17.8 months-35 months). Neurosurgery was responsible for the highest average amount paid per claim, and OMFS the lowest. Failure/delay in treatment and/or diagnosis and failure to warn/adequately consent were the three leading types of claim. 806 never events were successfully claimed for during the ten-year period. DISCUSSION AND CONCLUSION: Sharing information and good practice should be a priority for surgical professionals. Lessons learnt from medico-legal claims are transferrable in strategic planning. This pan-speciality report has demonstrated considerable burden on the NHS and should promote improvement in practice on an individual level in addition to providing systems based recommendations to NHS and international organisations.


Assuntos
Especialidades Cirúrgicas/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência , Humanos , Jurisprudência , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/estatística & dados numéricos , Medicina Estatal/economia , Medicina Estatal/estatística & dados numéricos , Reino Unido/epidemiologia
6.
J Surg Res ; 212: 48-53, 2017 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-28550921

RESUMO

BACKGROUND: Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. METHODS: The Westlaw database was searched for jury verdicts and settlements using the terms "medical malpractice" and "pancreaticoduodenectomy". Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. RESULTS: Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). CONCLUSIONS: The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed.


Assuntos
Imperícia/estatística & dados numéricos , Pancreaticoduodenectomia/legislação & jurisprudência , Especialidades Cirúrgicas/legislação & jurisprudência , Bases de Dados Factuais , Erros de Diagnóstico/legislação & jurisprudência , Erros de Diagnóstico/estatística & dados numéricos , Humanos , Imperícia/economia , Imperícia/legislação & jurisprudência , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/estatística & dados numéricos , Estados Unidos , Procedimentos Desnecessários/estatística & dados numéricos
7.
Int J Surg ; 40: 14-16, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28192246

RESUMO

Negligence claims in the UK NHS has increased over the last 30 years. The aim of this present study was determine the number of claims and the cost of litigation in Bariatric Surgery and compare it to similar other specialties. Data was received from NHS Litigation Authority (NHSLA) in response to Freedom of Information data request. There was a total of 7 claims, of which 4 were successful. The total pay out sum was £210,000 in 10 years. This is a very low amount compared to other surgical specialties. This low level of litigation probably indicates that the current bariatric surgical services in the NHS are delivering safe care with good patient satisfaction. This needs to be carefully considered prior to changing the payment tariffs for bariatric surgery.


Assuntos
Cirurgia Bariátrica/legislação & jurisprudência , Imperícia , Especialidades Cirúrgicas/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência , Cirurgia Bariátrica/estatística & dados numéricos , Compensação e Reparação/legislação & jurisprudência , Custos e Análise de Custo , Humanos , Imperícia/economia , Imperícia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Reino Unido
8.
J Surg Res ; 206(1): 206-213, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27916363

RESUMO

BACKGROUND: In Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to "tip the scales of justice"; or minimize the risks of being named in a malpractice claim. MATERIALS AND METHODS: The course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms. An anonymous seven question survey was cast in a five-point Likert scale format. A weighted average of 4.5 or above was considered satisfactory. Two free text questions asked about positive and negative aspects of the course. RESULTS: Eighty of 95 (84%) faculty attended either in person or by reviewing a web-based video. Quantitatively, five of seven questions had a weighted average of more than 4.5 (n = 48, response rate = 60%). Qualitatively, the course was reviewed very favorably. CONCLUSIONS: The high percentage of participation and overall survey results suggest that the course was successful. This course was one facet of an approach to decrease the risk of malpractice claims. Unique aspects of this course include an emphasis on state law, department-specific data, and strategies to minimize risk of future claims. Given the state-specific nature of malpractice claims and litigation, individual departments must particularize similar presentations.


Assuntos
Educação Médica Continuada , Docentes de Medicina/educação , Imperícia/legislação & jurisprudência , Especialidades Cirúrgicas/educação , Cirurgiões/educação , Atitude do Pessoal de Saúde , Currículo , Docentes de Medicina/legislação & jurisprudência , Humanos , Pennsylvania , Relações Médico-Paciente , Gestão de Riscos , Especialidades Cirúrgicas/legislação & jurisprudência , Cirurgiões/legislação & jurisprudência , Inquéritos e Questionários
9.
Handchir Mikrochir Plast Chir ; 48(2): 101-7, 2016 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-27096208

RESUMO

INTRODUCTION: The Arbitration Board for Medical Liability Issues of the Medical Association of North Germany ("Norddeutsche Schlichtungsstelle") is responsible for 10 federal states in Germany (Berlin, Brandenburg, Bremen, Hamburg, Mecklenburg-Western Pomerania, Lower Saxony, Saarland, Saxony-Anhalt, Schleswig-Holstein and Thuringia) and is the largest arbitration board in Germany. The data available from the Norddeutsche Schlichtungsstelle provides an insight into sources of malpractice during the treatment of reduction mammoplasty. MATERIAL UND METHODS: We analysed patient request, expert opinions prepared by independent physicians on behalf of the Norddeutsche Schlichtungsstelle and the final verdicts of 88 arbitration proceedings after breast reduction mammoplasties performed between 2000 and 2007. This data allows for each case to be addressed from different viewpoints. Furthermore we analysed the statistical data entered into the Medical Error Reporting System by the arbitration board. RESULTS: Among the 88 patient requests after reduction mammoplasty, the arbitration board found a causal relationship between damage caused to a patient's health and medical malpractice in 37 cases. Therefore, 42% of requests resulted in a liability case. This is a higher rate than that of general arbitration proceedings, where only in 24% of all cases a causal relationship is confirmed by the Norddeutsche Schlichtungsstelle. Most patients were operated on by gynaecologists. In 92% of liability cases, mistakes happened during the planning and the performance of the surgical procedure, mainly during planning (65%) and surgical incisions (41%). The patients mainly complained about scars (78%), asymmetry (68%) and skin necrosis of the areola (24%). Financial disadvantage was mentioned less often (46%) than psychological stress (70%). DISCUSSION: The higher rate of liability claims may be due to the fact the surgical procedures changing the shape of breasts are more complex than generally expected. Not only the surgery itself, but also the adequate planning and aftercare are of predominant importance for patient satisfaction. All these factors lead to the relatively high rate of medical malpractice in plastic aesthetic breast surgery. Also the communication factor should not be underestimated.


Assuntos
Prova Pericial/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Mamoplastia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Negociação , Adulto , Competência Clínica/legislação & jurisprudência , Compensação e Reparação/legislação & jurisprudência , Feminino , Alemanha , Humanos , Reoperação , Especialidades Cirúrgicas/legislação & jurisprudência
10.
Chirurg ; 86(11): 1034-40, 2015 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-25673117

RESUMO

BACKGROUND: Wrong site surgery defines a category of rare but totally preventable complications in surgery and other invasive disciplines. Such complications could be associated with severe morbidity or even death. As such complications are entirely preventable, wrong site surgery has been declared by the World Health Organization to be a "never event". MATERIAL AND METHODS: A selective search of the PubMed database using the MeSH terms "wrong site surgery", "wrong site procedure", "wrong side surgery" and "wrong side procedure" was performed. RESULTS: The incidence of wrong site surgery has been estimated at 1 out of 112,994 procedures; however, the number of unreported cases is estimated to be higher. Although wrong site surgery occurs in all surgical specialities, the majority of cases have been recorded in orthopedic surgery. Breakdown in communication has been identified as the primary cause of wrong site surgery. Risk factors for wrong site surgery include time pressure, emergency procedures, multiple procedures on the same patient by different surgeons and obesity. Check lists have the potential to reduce or prevent the occurrence of wrong site surgery. CONCLUSION: The awareness that to err is human and the individual willingness to recognize and prevent errors are the prerequisites for reducing and preventing wrong site surgery.


Assuntos
Erros Médicos/estatística & dados numéricos , Causas de Morte , Estudos Transversais , Alemanha , Humanos , Incidência , Imperícia/legislação & jurisprudência , Erros Médicos/mortalidade , Erros Médicos/prevenção & controle , Segurança do Paciente/legislação & jurisprudência , Fatores de Risco , Especialidades Cirúrgicas/legislação & jurisprudência , Especialidades Cirúrgicas/estatística & dados numéricos
11.
Eur J Pediatr Surg ; 25(1): 66-70, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25526607

RESUMO

AIMS OF THE STUDY: We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. MATERIALS AND METHODS: We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. RESULTS: Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims.


Assuntos
Compensação e Reparação/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Pediatria/legislação & jurisprudência , Especialidades Cirúrgicas/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência , Criança , Inglaterra , Humanos , Imperícia/economia , Imperícia/estatística & dados numéricos , Imperícia/tendências , Pediatria/economia , Pediatria/estatística & dados numéricos , Pediatria/tendências , Estudos Retrospectivos , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/estatística & dados numéricos , Especialidades Cirúrgicas/tendências , Medicina Estatal/economia , Medicina Estatal/estatística & dados numéricos , Medicina Estatal/tendências
15.
Dtsch Med Wochenschr ; 139(1-2): 47-52, 2014 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-24390850

RESUMO

The new Patients' Rights Act does not reflect rights of patients as professional obligations of physicians for the first time. It adopted common longtime jurisdiction, but in some respects it is going beyond. This law clearly extends the documentation requirements of physicians, especially concerning the extent of documentation. In surgical fields the requirements for enlightening physicians were more strongly worded than in previous jurisdiction. In medical facilities it is now mandatory to establish an internal quality management system.


Assuntos
Programas Nacionais de Saúde/legislação & jurisprudência , Defesa do Paciente/legislação & jurisprudência , Especialidades Cirúrgicas/legislação & jurisprudência , Compensação e Reparação/legislação & jurisprudência , Alemanha , Humanos , Imperícia/legislação & jurisprudência , Equipe de Assistência ao Paciente/legislação & jurisprudência , Educação de Pacientes como Assunto/legislação & jurisprudência , Participação do Paciente/legislação & jurisprudência , Segurança do Paciente/legislação & jurisprudência , Política
16.
Zentralbl Chir ; 138(1): 45-52, 2013 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-22403014

RESUMO

BACKGROUND: The question of whether a medical care unit is an appropriate tool for outpatient care has been discussed for a long time. Our aim is to investigate whether the MCU is an effective instrument for outpatient care and adequate performance-related remuneration. MATERIAL AND METHODS: This retro- and prospective overview of the work included statements on legal foundations for medical care units, for reimbursement of services in medical care units, the development of medical care centres in Germany and a listing of the specific advantages and disadvantages of an MCU. This article focuses on the generally applicable facts and complements them with examples from general, visceral and vascular surgery. The main quantitative data on medical centre statistics come from different publications of the National Association of Statutory Health Insurance for Physicians. RESULTS: From a legal point of view the instrument MCU allows the participating of ambulatory and stationary care in the framework of medical care contracts. This has been especially extended for stationary applications, including the spectrum of possibilities that can contribute under certain circumstances for the provision of medical care in underdeveloped regions. Freelancers can benefit primarily from financial risk and minimising bureaucratic routine. The remuneration for services performed in the MCU is analogous to that of other ambulatory care providers. Basically, there are no disadvantages, but a greater design freedom and opportunities for the generation of aggregates are visible. The number of MCU in Germany has quadrupled in the last five years, indicating an establishment of an outpatient care landscape. MCU offers from the patient's perspective, providers and policy specific advantages and disadvantages. Indeed the benefits outweigh the disadvantages, but this is not yet verified by qualitative studies. CONCLUSION: The question of the appropriateness of medical care units as outpatient care instrumentation must be considered differentially. Under current conditions it appears suitable for ensuring the MCU and the supplement of care supply. Whether a value can be generated in the quality of care of patients, however, has to be examined separately, as there are no valid data so far. The same applies to economic assessments of costs and benefits from an economic perspective.


Assuntos
Programas Nacionais de Saúde/economia , Ambulatório Hospitalar/economia , Ambulatório Hospitalar/organização & administração , Reembolso de Incentivo/economia , Remuneração , Serviços Contratados/economia , Serviços Contratados/legislação & jurisprudência , Comportamento Cooperativo , Análise Custo-Benefício , Cirurgia Geral/economia , Cirurgia Geral/legislação & jurisprudência , Alemanha , Humanos , Comunicação Interdisciplinar , Programas Nacionais de Saúde/legislação & jurisprudência , Ambulatório Hospitalar/legislação & jurisprudência , Estudos Prospectivos , Reembolso de Incentivo/legislação & jurisprudência , Estudos Retrospectivos , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/legislação & jurisprudência , Procedimentos Cirúrgicos Vasculares/economia , Procedimentos Cirúrgicos Vasculares/legislação & jurisprudência , Vísceras/cirurgia
18.
Am J Surg ; 203(6): 733-40, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22643038

RESUMO

INTRODUCTION: We postulated that a closed claim review of surgical cases would identify not only the quality of care elements but also factors that will predict successful legal outcomes. METHODS: One hundred eighty-seven closed surgical cases from a single carrier, which insured physicians practicing in 4 university hospitals in New York State, were reviewed, cataloged, and analyzed. RESULTS: Most suits occurred during midcareer and routine operations. Seventy-three percent of cases were won. The average payment and expenses per case were $220,846 ± $38,984 and $40,175 ± $4,204, respectively. Poor communication was identified in 24% of cases and was a predictor of a negative outcome (41% lost, P < .05), as was inadequate attending supervision (46% lost, P < .05). Expert reviews incriminated or exculpated physician defendants in 85 cases, which affected the outcome and cost. The quality of the physician defendant as a witness also affected the outcome. CONCLUSIONS: Most surgical malpractice claims are won. Although supervision, communication, and aggressive risk management are important, the use of quality experts and establishing credibility of the physician defendant are critical for successful legal outcome.


Assuntos
Revisão da Utilização de Seguros , Seguro de Responsabilidade Civil/economia , Imperícia/economia , Corpo Clínico Hospitalar , Especialidades Cirúrgicas , Adulto , Comunicação , Prova Pericial/economia , Hospitais Universitários , Humanos , Imperícia/legislação & jurisprudência , Corpo Clínico Hospitalar/economia , Corpo Clínico Hospitalar/legislação & jurisprudência , Pessoa de Meia-Idade , New York , Qualidade da Assistência à Saúde , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/legislação & jurisprudência
19.
J Craniofac Surg ; 23(1): 298-300, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22337429

RESUMO

Craniofacial surgeons repair a wide variety of soft and hard tissues that produce the clinical expertise to recognize the need for an improved device or novel regenerative stem cell or use of molecules that may dramatically change the way clinical care for improved patient outcomes. The business pathway to bring a concept to clinical care requires knowledge, mentoring, and a team of experts in business and patent law.


Assuntos
Face/cirurgia , Ossos Faciais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Crânio/cirurgia , Especialidades Cirúrgicas/organização & administração , Centros Médicos Acadêmicos/economia , Centros Médicos Acadêmicos/legislação & jurisprudência , Biotecnologia/economia , Biotecnologia/legislação & jurisprudência , Biotecnologia/organização & administração , Comércio/legislação & jurisprudência , Contrato de Risco/economia , Contrato de Risco/legislação & jurisprudência , Contrato de Risco/organização & administração , Apoio Financeiro , Humanos , Propriedade Intelectual , Mentores , Patentes como Assunto/legislação & jurisprudência , Administração da Prática Médica/legislação & jurisprudência , Administração da Prática Médica/organização & administração , Prática Privada/economia , Prática Privada/legislação & jurisprudência , Procedimentos Cirúrgicos Reconstrutivos/economia , Procedimentos Cirúrgicos Reconstrutivos/legislação & jurisprudência , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/legislação & jurisprudência
20.
Am J Surg ; 204(5): 800-2, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21872206

RESUMO

Risk for a lawsuit for medical malpractice has unfortunately become part of physicians' daily professional activities, with a blowout in indemnity insurance premiums, especially in high-risk medical specialties. Common bile duct injury following laparoscopic cholecystectomy is a well-recognized and feared complication for surgeons because of its associated morbidity, and it also ranks among the leading sources of medical malpractice claims against surgeons in the world. The purpose of this article is to raise awareness within the medical community and in particular among specialist surgeons on the important threat they could be facing in terms of litigation in the event of an adverse surgical outcome following such a commonly performed procedure. There is a real need for open debate on this concerning topic, as the fear of lawsuits and exorbitant malpractice premiums are pushing a substantial number of medical professionals to practice defensive medicine, reflected by the avoidance of performing certain procedures or treating high-risk patients perceived to have higher litigation rates, or simply walking away from their current practices, creating a chronic shortage of specialized doctors in certain surgical areas.


Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Ducto Colédoco/lesões , Cirurgia Geral/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Austrália , Colecistectomia Laparoscópica/economia , Colecistectomia Laparoscópica/legislação & jurisprudência , Cirurgia Geral/economia , Humanos , Seguro de Responsabilidade Civil/economia , Imperícia/economia , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/legislação & jurisprudência , Estados Unidos
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