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1.
Int J Oral Implantol (Berl) ; 14(1): 57-66, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-34006071

RESUMO

PURPOSE: In recent years, dental malpractice claims have increased dramatically worldwide. The present study aimed to categorise and analyse claims related to implant dentistry that resulted in legal decisions in Israel, seeking to contribute to dental risk management and improve patient safety. MATERIALS AND METHODS: This study analysed legal claims registered by Medical Consultants International between 2005 and 2015. Only closed cases in which a decision was made were included. The parameters studied included patient age and sex, date of the complaint, treatment setting (private/public clinic), description of the adverse event and type of negligence claimed. RESULTS: The cohort included 709 settled claims out of a total of 1066 that were litigated against dental practitioners in Israel during the study period. Of the patients included, 60.0% were women and 63.9% were aged 40 to 59 years. The most common treatment-related damage was neural injury in 133 patients (18.7% of the cohort). Unplanned changes in the treatment plan and violation of autonomy were the most frequent documentation-/information-related claims (66.3% and 32.7%, respectively). The legal responsibility of the dental practitioner was acknowledged in 89.0% of cases. Dental practitioners working in the private sector were more likely to be sued due to violation of autonomy than those working in public clinics. CONCLUSIONS: Although the main cause for lawsuits was actual bodily injury, the high percentage of documentation-/information-related malpractice claims calls for increased awareness of patients' autonomy and rights. Practitioners should dedicate a significant part of the entire treatment time to preoperative diagnosis and planning.


Assuntos
Implantes Dentários , Imperícia , Adulto , Implantes Dentários/efeitos adversos , Odontólogos , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Papel Profissional
3.
Zhonghua Yi Xue Za Zhi ; 101(19): 1381-1402, 2021 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-34034367

RESUMO

The Civil Code of the People's Republic of China (hereinafter referred to as the "Civil Code") has been implemented on January 1, 2021. The "Civil Code" involves clinical medical diagnosis and treatment work legal norms and legal liabilities. Except for the revisions of the key contents of the "Medical Damage Liability" part of the Tort Liability Law, most of them remains following the original regulations. In order to enable the managers and medical staff of medical institutions to fully understand the relevant provisions of the Civil Code and their clinical applications, this article is divided into ten parts for a comprehensive and systematic interpretation.


Assuntos
Imperícia , China , Humanos , Responsabilidade Legal
4.
BMC Health Serv Res ; 21(1): 516, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049554

RESUMO

BACKGROUND: How much does the medical malpractice system affect treatment decisions in orthopaedics? To further this inquiry, we sought to assess whether malpractice liability is associated with differences in surgery rates among elderly orthopaedic patients. METHODS: Medicare data were obtained for patients with a rotator cuff tear or proximal humerus fracture in 2011. Multivariate regressions were used to assess whether the probability of surgery is associated with various state-level rules that increase or decrease malpractice liability risks. RESULTS: Study results indicate that lower liability is associated with higher surgery rates. States with joint and several liability, caps on punitive damages, and punitive evidence rule had surgery rates that were respectively 5%-, 1%-, and 1%-point higher for rotator cuff tears, and 2%-, 2%- and 1%-point higher for proximal humerus fractures. Conversely, greater liability is associated with lower surgery rates, respectively 6%- and 9%-points lower for rotator cuff patients in states with comparative negligence and pure comparative negligence. CONCLUSIONS: Medical malpractice liability is associated with orthopaedic treatment choices. Future research should investigate whether treatment differences result in health outcome changes to assess the costs and benefits of the medical liability system.


Assuntos
Imperícia , Lesões do Manguito Rotador , Idoso , Estudos de Coortes , Humanos , Úmero , Medicare , Manguito Rotador , Lesões do Manguito Rotador/cirurgia , Estados Unidos/epidemiologia
5.
J Law Med Ethics ; 49(1): 126-131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33966655

RESUMO

Workplace exposure to SARS-CoV-2 has sickened workers and, subsequently, their family members. Family members might be able to recover from the employer in a negligence action using "take-home" liability theory.


Assuntos
/transmissão , Compensação e Reparação/legislação & jurisprudência , Família , Responsabilidade Legal , Exposição Ocupacional/legislação & jurisprudência , Humanos , Imperícia/legislação & jurisprudência , Estados Unidos , United States Occupational Safety and Health Administration/legislação & jurisprudência , Indenização aos Trabalhadores/legislação & jurisprudência
7.
BMC Health Serv Res ; 21(1): 324, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33836746

RESUMO

BACKGROUND: Physicians who perform unsafe practices and harm patients may be disciplined. In Norway, there are five types of disciplinary action, ranging from a warning for the least serious examples of malpractice to loss of licence for the most serious ones. Disciplinary actions always involve medical malpractice. The aims of this study were to investigate the frequency and distribution of disciplinary actions by the Norwegian Board of Health Supervision for doctors in Norway and to uncover nation-wide patient safety issues. METHODS: We retrospectively investigated all 953 disciplinary actions for doctors given by the Board between 2011 and 2018. We categorized these according to type of action, recipient's profession, organizational factors and geographical location of the recipient. Frequencies, cross tables, rates and linear regression were used for statistical analysis. RESULTS: Rural general practitioners received the most disciplinary actions of all doctors and had their licence revoked or restricted 2.1 times more frequently than urban general practitioners. General practitioners and private specialists received respectively 98.7 and 91.0 disciplinary actions per 1000 doctors. Senior consultants and junior doctors working in hospitals received respectively 17.0 and 6.4 disciplinary actions per 1000 doctors. Eight times more actions were received by primary care doctors than secondary care doctors. Doctors working in primary care were given a warning 10.6 times more often and had their licence revoked or restricted 4.6 times more often than those in secondary care. CONCLUSION: The distribution and frequency of disciplinary actions by the Norwegian Board of Health Supervision clearly varied according to type of health care facility. Private specialists and general practitioners, especially those working in rural clinics, received the most disciplinary actions. These results deserve attention from health policy-makers and warrant further studies to determine the factors that influence medical malpractice. Moreover, the supervisory authorities should assess whether their procedures for reacting to malpractice are efficient and adequate for all types of physicians working in Norway.


Assuntos
Imperícia , Médicos , Humanos , Noruega , Estudos Retrospectivos , Especialização
8.
J Forensic Leg Med ; 80: 102170, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33878590

RESUMO

Defensive medicine is a practice that has been utilized by clinicians in efforts of preventing patient dissatisfaction and malpractice claims and may be done through either omission or commission. As much as 57% of physicians have disclosed that they practice defensive medicine. However, this practice does not necessarily prevent malpractice claims and more importantly, neither does it equate to good medical practice, with some leading to poor outcomes. Unfortunately, there is a high percentage of malpractice claims lodged against clinicians in both primary care and hospital settings. Specialists such as surgeons, obstetricians, and gynecologists face the highest claims. In particular, during the SARS CoV-2 pandemic, with new challenges and limited treatment algorithms, there is an even greater concern for possible bourgeoning claims. Counteracting defensive medicine can be accomplished through decriminalizing malpractice claims, leaving physician oversight up to state medical boards and hospital claims management committees. Additional tort reform measures must also be taken such as caps on noneconomic damages to ensure emphasis on beneficence and nonmaleficence. Once these are in place, it may well serve to increase clinician-patient trust and improve patient independence in the shared decision-making process of their treatment, allowing clinicians to practice their full scope of practice without feeling wary of potential malpractice claims.


Assuntos
Medicina Defensiva , COVID-19 , Humanos , Seguradoras , Responsabilidade Legal , Imperícia , Pandemias , Procedimentos Desnecessários
9.
Artigo em Inglês | MEDLINE | ID: mdl-33806174

RESUMO

Over the past two decades, health litigation has followed an exponentially incremental trend. As insurance companies tend to limit their interest because of the high risk of loss, health facilities increasingly need to internalize dispute management. This study was conducted through a retrospective analysis of existing files concerning the civil litigation of the Sant'Andrea Hospital in Rome. All claims from 1 June 2010 to 30 June 2019 were included. Paid claims were further classified according to the areas of health care inappropriateness found. Authors indexed 567 different claims along the study period, with an average number of 59 per year (range 38-77). The total litigation involved 47 different units; more than 40% concerned 5 high-incidence wards or services. Concerning the course of disputes, 91 cases were liquidated before a judicial procedure was instituted, while 177 cases landed in a civil court. Globally, 131 different claims hesitated in compensation, for a total of 16 million 625 thousand euros, 41% of which was related to the internal medicine area. Dealing with the inappropriateness analysis, clinical performance alone involved 76 cases, for a total of 10 million 320 thousand euros, while organization defects involved 20 disputes equivalent to 1 million 788 thousand euros. The aim of this study was to enhance the clinical risk management at our facility through a litigation analysis.


Assuntos
Responsabilidade Legal , Imperícia , Compensação e Reparação , Hospitais , Estudos Retrospectivos
10.
Rev. ADM ; 78(2): 80-83, mar.-abr. 2021. tab
Artigo em Espanhol | LILACS | ID: biblio-1247499

RESUMO

El consentimiento informado forma parte de los elementos que constituyen el expediente clínico. Por su importancia informativa sobre posibles riesgos y complicaciones inherentes al tratamiento a realizar, su elaboración resulta de vital importancia. Existen numerosas legislaciones y normatividades que regulan este notable documento; sin embargo, resulta alarmante que muchos profesionistas omiten su realización o lo elaboran erróneamente, poniéndolos en riesgo de sufrir problemas legales. Además, es una realidad que el consentimiento informado es un documento mal entendido por la mayoría de los profesionistas, pudiendo incurrir en numerosos errores por desconocimiento. El objetivo del presente artículo es informar al cirujano dentista sobre los verdaderos alcances del consentimiento informado con fundamento en la legislación vigente en México (AU)


Informed consent is part of the elements that make up the clinical record. Due to its informative importance on possible risks and complications inherent to the treatment to be carried out, its preparation is of vital importance. There are numerous laws and regulations that regulate this remarkable document, however, it is alarming that many professionals omit its elaboration or wrongly elaborate it, putting them at risk of suffering legal problems. In addition, it is a reality that informed consent is a document misunderstood by most professionals, and may incur numerous errors due to ignorance. The aim of this article is to inform the dental surgeon about the true scope of informed consent based on current legislation in Mexico (AU)


Assuntos
Humanos , Responsabilidade Legal , Odontologia Legal/legislação & jurisprudência , Consentimento Livre e Esclarecido , Registros Odontológicos/legislação & jurisprudência , Legislação Odontológica , Imperícia/legislação & jurisprudência , México
12.
Ginekol Pol ; 92(3): 216-219, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33751519

RESUMO

This paper is entirely devoted to a new legal instrument called the "Good Samaritan Clause". Its legal recognition constitutes the legislator's response to the concerns raised by the medical community, in view of the unique situation in the country, but also in the world, relating to the prevention, counteraction and suppression of COVID-19. The assumption is that this instrument is to constitute a countertype that excludes the criminal unlawfulness of the act, due to the increased risk of mistakes made by the physicians involved in providing health services during the epidemic. The paper focuses primarily on the dogmatic and legal issues, discussing the catalogue of conditions needed for the application of the instrument mentioned in the title, but it also attempts to critically evaluate the introduced solution. The idea itself of introducing a solution affecting the scope of criminal liability of physicians is good, however, it requires legislative clarification as well.


Assuntos
/epidemiologia , Responsabilidade Legal , Pandemias , Médicos/legislação & jurisprudência , Humanos , Imperícia/legislação & jurisprudência , Polônia/epidemiologia
16.
Med Sci Law ; 61(1_suppl): 141-145, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33591862

RESUMO

The trend for medical malpractice claims has increased in recent years, both in the USA and in Europe. Although diagnostic radiology is not considered a high-risk field, malpractice claims in this area follow this general trend. The most common legal action taken against radiologists includes failure to diagnose, poor communication between physicians, failure to supervise technologists properly and improper procedures. Recently, the Italian Civil Supreme Court delivered a judgment (Cass. Civ., N.10158-18) regarding the liability of radiologists, stating that in radiological practice, a correct and timely execution of the diagnostic investigation is required. By contrast, the same judgment states that requesting further clinical consultations and/or the execution of in-depth diagnostic examinations are not within their duties. Considering this judgment, we report two cases of radiologist malpractice and related responsibility for negligent conduct regarding the diagnosis of thoracic aortic dissection and the prevention and management of acute aortic syndrome.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Responsabilidade Legal , Imperícia/legislação & jurisprudência , Radiografia , Radiologistas/legislação & jurisprudência , Idoso , Feminino , Humanos , Itália , Masculino , Imperícia/tendências , Pessoa de Meia-Idade
17.
Ulus Travma Acil Cerrahi Derg ; 27(2): 207-213, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33630295

RESUMO

BACKGROUND: By examining patients with testicular torsion (TT) that caused problems in medicolegal terms, the present study aims to define markers causing medical neglect or malpractice in similar conditions and perform a retrospective examination to characterize the medical aspects of patients with TT. METHODS: In this study, 53 patients who underwent orchiectomy for TT following interventions made between 2004 and 2019 in different hospitals of Turkey and had satisfactory clinical findings in their files based on medicolegal inspections were included. RESULTS: The median age of the patients was nine years. Twenty-three (43.4%) of the patients had TT on the left side, 29 (54.7%) had TT on the right side, and one (1,9%) patient had bilateral TT. It was noticed that 31 (58.5%) patients had epididymo-orchitis (EO), seven patients had (13.2%) urinary infection, five (9.4%) patients had a hydrocele, and four (7.5%) patients had renal colic, and the others had testicle contusion, gastroenteritis, inguinal hernia, and acute appendicitis as misdiagnoses. The mean time that passed between admission and TT diagnosis was detected as 59±11.2 hours. A statistically significant relation was detected between the branch of the physician who first evaluated the patients and the presence of performing scrotal examination and imaging during admission. The ratio of physical scrotal examinations by emergency service physicians was lower than with the urologists. Among the preliminary examiner allowed to be an advanced evaluation for the possibility of missing diagnosis by an independent specialist physicians, 25 (47.2%) were urologists, 22 (41.5%) were emergency service physicians, four (7.5%) were pediatricians, and two (3.8%) were radiologists. CONCLUSION: Physicians should perform the required evaluations for a suitable diagnosis and treatment by putting aside their medicolegal concerns and prevent the problems by giving priority to patient health. For the correct diagnosis and proper management of TT, it is necessary to increase the information levels of physicians, and patients should be explored urgently in the event of any clinical suspicion.


Assuntos
Diagnóstico Ausente/legislação & jurisprudência , Torção do Cordão Espermático/diagnóstico , Torção do Cordão Espermático/epidemiologia , Criança , Humanos , Masculino , Imperícia , Exame Físico , Estudos Retrospectivos , Turquia
18.
Artigo em Inglês | MEDLINE | ID: mdl-33435324

RESUMO

Despite numerous measures to contain the infection and limit its spread, cases of SARS-CoV-2 infections acquired in hospitals have been reported consistently. In this paper, we will address issues of hospital-acquired COVID-19 in hospitalized patients as well as medico-legal implications. After having conducted a literature search, we will report on papers on hospital-acquired SARS-CoV-2 infections. Ten scientific papers were selected and considered suitable for further analysis. According to several reports, the SARS-CoV-2 hospital-acquired infection rate is 12-15%. Hospital-acquired COVID-19 represents a serious public health issue, which is a problem that could create reluctance of patients to seek hospital treatment for fear of becoming infected. Healthcare personnel should do all that is necessary to address the problem and prevent further spreading, such as rigorous compliance with all procedures for containing the spread. From a medical-legal point of view, multiple aspects must be considered in order to understand whether the infection is a result of "malpractice" or an inevitable condition.


Assuntos
/etiologia , Infecção Hospitalar/virologia , Hospitais , Imperícia , Pessoal de Saúde , Humanos
19.
J Forensic Leg Med ; 78: 102123, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33516144

RESUMO

The dental profession is considered at high potential risk of exposure and transmission of SARS-Cov-2. Thus, dentists should implement special safety measures in order to prevent any possible contamination during dental sessions and should be aware of the legal implications of their act in order to avoid malpractice leading them to be a causative agent of transmission of this virus. This paper aimed to provide a global review on COVID-19 preventive recommendations at dental clinics and discussed the legal values of such procedures, the dentist criminal and civil liability arising from transmitting this virus to a patient, the obligation of care under COVID-19 and the possible solution to this dilemma. The review concluded that dentists should follow all modern scientific procedures which are in their interest and in the interest of patients to maintain their safety and advised dentists to document all steps taken during the period of COVID-19 outbreak, because any undocumented action is considered not to have taken place, and they shall be bound by the burden of proof.


Assuntos
/prevenção & controle , Odontólogos/legislação & jurisprudência , Responsabilidade Legal , Padrões de Prática Odontológica/legislação & jurisprudência , Gestão da Segurança/normas , Padrão de Cuidado/legislação & jurisprudência , Clínicas Odontológicas , Humanos , Imperícia/legislação & jurisprudência
20.
J Oral Maxillofac Surg ; 79(5): 1026.e1-1026.e8, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33515506

RESUMO

PURPOSE: Our study fills the vacancy of litigation research related to trigeminal neuralgia management, giving health care providers the information needed to understand the potential litigious outcomes that follow treatment methods. METHODS: We queried the Westlaw database to identify litigation cases related to trigeminal neuralgia management. Key variables extracted included medical complaints, trial outcomes, and demographics. Continuous variables were compared between cases in favor of defendant and cases in favor of plaintiff using t-test or Wilcoxon rank sum test. Categorial variables were compared using χ2 or Fisher exact test. RESULTS: About 49 cases met the inclusion criteria-for those cases surgical complications (42.9%) were cited as the most common reasons for malpractice claims. Cranial nerve deficits (34.7%) were the most frequent postoperative complaints. Verdicts ruled in favor of the plaintiff in 26.5% of cases with a mean payout of $1,982,428.46. Dentists were included in the most cases, 63.3%, and the average payout was $415,908, whereas neurosurgeons were involved in 20.4% of cases with an average payout of $618,775. Cases with verdicts in favor of the plaintiff were more likely to be older than cases with verdicts in favor of the defendant (P = .03). CONCLUSIONS: Over one-half of cases resulted in verdicts in favor of the defendant with surgical complications cited as the most common reason for litigation. Dentistry was the most common individual clinical specialty for defendants, whereas neurosurgery contributed to the largest average payout based on specialty (for n > 1). Cranial nerve deficits were the most common plaintiff postoperative complaints. These analyses may help doctor teams involved in management of trigeminal neuralgia to have a more informed discussion with the patient at every visit so that such litigations may be avoided.


Assuntos
Imperícia , Neuralgia do Trigêmeo , Bases de Dados Factuais , Pessoal de Saúde , Humanos , Neuralgia do Trigêmeo/cirurgia
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