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1.
Braz. j. oral sci ; 21: e225074, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1354769

RESUMO

The relationship between patients and dentists today is more worn and less based on trust, which can lead to high rates of lawsuits related to civil liability and dental malpractice. Aim: verify if there has been an increase in the number of lawsuits related to questioned dental treatments, and against dentists registered in the city of São Paulo (SP), Brazil, from 2012 to 2017. Methods: We outlined an overview based on the list from the São Paulo Council of Dentistry containing 30,238 registered dentists in the city of São Paulo, and searched for lawsuits on the public base of the São Paulo State Court's. Results: The search, after the inclusion and exclusion criteria, found 247 lawsuits, with dental implants as the most involved specialty. The total indemnities requested ranged from R$ 227.42 to R$ 937,000.00, but no indemnity granted exceeded the amount of R$ 100,000.00. Conclusion: According to the analysis of cases, there is a progressive increase in the number of civil liability lawsuits against dentists involving dental malpractice litigance


Assuntos
Dano ao Paciente , Odontologia Legal , Seguro de Responsabilidade Civil , Jurisprudência
3.
Front Public Health ; 10: 897386, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832274

RESUMO

Environmental pollution liability insurance (EPLI) is a type of insurance purchased by an enterprise to compensate the loss of the victims in the event of an environmental pollution incident. Although EPLI can realize the post-treatment of environmental pollution to a certain extent, there is still less understanding of whether EPLI can improve the environmental performance of enterprises. This study takes A-share listed companies in heavily polluting industries as the research object, determines the treatment group samples according to the Insurance coverage list published by the Ministry of Environmental Protection in 2014 and 2015, and then constructs the empirical test model. In order to ensure that there is no sample selection bias, the PSM method is used to preprocess the samples in this study to ensure the robustness of the conclusions. The empirical tests show that EPLI can significantly improve corporate environmental performance. Further analysis showed that higher public visibility is conducive to the positive environmental effects of EPLI. Compared with state-owned enterprises, non-state-owned enterprises have more significant implementation effects after introducing EPLI. On further examination, the result indicates that environmental pollution liability insurance can improve environmental performance by alleviating corporate financing constraints. The findings of this paper enrich the theory of the economic impact of environmental pollution liability insurance, which has some meaningful theoretical guidance for enterprises and policy makers.


Assuntos
Poluição Ambiental , Seguro de Responsabilidade Civil , China , Conservação dos Recursos Naturais , Indústrias
4.
Nursing ; 52(8): 51-54, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35866862

RESUMO

ABSTRACT: This article discusses the risks of practicing without professional liability insurance and offers recommendations for nurses, especially those facing a state board of nursing investigation, malpractice lawsuit, or criminal charge.


Assuntos
Responsabilidade Legal , Imperícia , Humanos , Seguro de Responsabilidade Civil
6.
Taiwan J Obstet Gynecol ; 61(1): 102-109, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35181016

RESUMO

OBJECTIVE: Increasing obstetric medical litigations had great impacts in health care system resulted in lower recruitment of residents and higher medical cost of defensive medicine in Taiwan. In order to reduce medical litigation, the "Childbirth Accident Emergency Relief Act" was implemented in June 2016. This study presented five-year results of a novel childbirth accident compensation system. MATERIALS AND METHODS: The purpose of the Relief Act was to establish a national relief system to ensure timely relief, reduce medical disputes, promote the partnership between patient and medical personnel. The compensations included maximal 2 million NTD for maternal death, maximal 0.3 million NTD for neonatal and fetal deaths, and 3, 2, and 1.5 million NTD for maternal or neonatal profound, severe, and moderate disabilities, respectively. Puerperal hysterectomy was included with maximal 0.8 million NTD compensation. RESULTS: Since June 30, 2016 to June 30, 2021, there were 1340 applications reviewed by Committee and 1258 were approved with total relief of 744.7 million NTD (26.6 million USD) with approve rate of 93.9%. It took an average of 109.8 days to start application from childbirth and 102.4 days to get compensation from application. 66.1% of accident victims agreed this system can restore doctor-patient relationship by immediate care and assistance from medical institutions. CONCLUSION: The Relief Act is the first government leading compensation system to establish a national relief system. It was enacted to reduce medical disputes, promote the partnership between patient and medical personnel, and enhance health and safety of women during childbirth. A no-fault compensation would be an efficient alternative disputes resolution to childbirth accidents.


Assuntos
Traumatismos do Nascimento , Compensação e Reparação/legislação & jurisprudência , Dissidências e Disputas , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Relações Médico-Paciente , Traumatismos do Nascimento/epidemiologia , Traumatismos do Nascimento/etiologia , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Seguro de Responsabilidade Civil , Responsabilidade Legal , Gravidez , Taiwan/epidemiologia
7.
J Cardiovasc Surg (Torino) ; 63(1): 106-113, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34338496

RESUMO

BACKGROUND: Aortic and mitral valve replacement are commonly performed by cardiovascular surgeons, but little data quantitatively analyzes the etiology and prevalence of medical malpractice litigations involving these operations. This study aims to analyze incidence, cause, and resolution of medical malpractice lawsuits involving aortic and mitral valve replacements, alone and in combination with coronary artery bypass and/or aortic procedures. METHODS: The Westlaw legal database was utilized to compile relevant litigations across the United States from 1994-2019. Clinical data, verdict data, demographic data, and litigation attributes were compiled. Fisher's Exact Tests and Mann-Whitney tests were performed for statistical analyses. One hundred four malpractice litigations involving aortic valve replacement and 55 litigations involving mitral valve replacement were included in this analysis. The mean age of patients was 55.2 years and proportion of female patients was 32.7% in aortic valve replacements litigations, compared to a mean age of 54.1 years and female patients in 61.8% of mitral valve replacements litigations. RESULTS: Significant relationships exist between an alleged failure to monitor the patient and defendant verdicts (P=0.01), delayed treatment and defendant verdicts (P=0.04), and incidence of infective endocarditis and plaintiff verdicts (P=0.04) in aortic valve replacement litigations. Similarly, significant relationships exist between an alleged failure to diagnose and settlement verdicts (P=0.047), and stroke incidence and defendant verdicts (P=0.03) in mitral valve replacement litigations. CONCLUSIONS: In addition to excellent surgeon patient/family communication, administering surgical treatment in a timely manner, diagnosing acting on concomitant medical conditions, and close patient monitoring may diminish medical malpractice litigation involving aortic and mitral valve replacement operations.


Assuntos
Valva Aórtica/cirurgia , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/legislação & jurisprudência , Seguro de Responsabilidade Civil/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Valva Mitral/cirurgia , Bases de Dados Factuais , Feminino , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Erros Médicos/efeitos adversos , Pessoa de Meia-Idade , Dano ao Paciente/legislação & jurisprudência , Má Conduta Profissional/legislação & jurisprudência , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Estados Unidos
8.
J Vasc Surg ; 75(3): 962-967, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34601048

RESUMO

OBJECTIVE/BACKGROUND: Thoracic outlet syndrome (TOS) is most often referred to vascular surgeons. However, there is a lack of understanding of the malpractice cases involving TOS. The goal of this study is to better understand the medicolegal landscape related to the care of TOS. METHODS: The Westlaw Edge AI-powered proprietary system was retrospectively reviewed for malpractice cases involving TOS. A Boolean search strategy was used to identify target cases under the case category of "Jury Verdicts & Settlements" for all state and federal jurisdictions from 1970 to September 2020. The settled case was described but not included in the statistical analysis. Descriptive statistics were used to report our findings, and when appropriate. The P ≤ .05 decision rule was established a priori as the null hypothesis rejection criterion to determine associations between jury verdicts outcomes and state's tort reform status. RESULTS: In this study, 39 cases were identified and met the study's inclusion criteria from the entire Westlaw Edge database. Among plaintiffs who disclosed age and/or gender, median age was 35.0 years with a female majority (67.6%). Cases involving TOS were noted to be steadily decreasing since the mid-1990s. The cases were unevenly spread across 18 states, with the highest number of cases (14, 35.9%) from California and the second highest (4, 10.3%) from Pennsylvania. A similar uneven distribution was seen among U.S. census regions, in which the West had the highest cases (39.5%). The study revealed that more cases were brought to trials in tort reform states (26, 68.4%) than in non-tort reform states (12, 31.6%). A total of 24 of 39 (61.5%) plaintiffs had one specific claim, which resulted in their economic and noneconomic damages. Negligent operation and treatment complication represented an overwhelming majority of claims brought by 38 of 39 plaintiffs (97.4%). Misdiagnosis and lack of informed consent were both brought nine times (23.1%) by the group. Intraoperative nerve injury (20 patients, 51.3%) was the most commonly reported complication. Excluding one case with a settlement of $965,000, 30 of 38 (78.9%) cases went to trials and received defense verdicts. Eight cases (20.5%) were found in favor of plaintiffs with a median payout of $725,581. CONCLUSIONS: This study highlighted higher than average payouts to plaintiffs and risk factors that may result in malpractice lawsuits for surgeons undertaking TOS treatment. Future studies are needed to further clarify the relationships between tort reform and outcomes of malpractice cases involving TOS.


Assuntos
Compensação e Reparação , Descompressão Cirúrgica/economia , Seguro de Responsabilidade Civil/economia , Responsabilidade Legal/economia , Imperícia/economia , Erros Médicos/economia , Complicações Pós-Operatórias/economia , Síndrome do Desfiladeiro Torácico/cirurgia , Procedimentos Cirúrgicos Vasculares/economia , Adulto , Compensação e Reparação/legislação & jurisprudência , Bases de Dados Factuais , Descompressão Cirúrgica/efeitos adversos , Descompressão Cirúrgica/legislação & jurisprudência , Feminino , Humanos , Seguro de Responsabilidade Civil/legislação & jurisprudência , Masculino , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Formulação de Políticas , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Síndrome do Desfiladeiro Torácico/economia , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/legislação & jurisprudência
10.
Healthc Policy ; 17(1): 30-41, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34543174

RESUMO

Many Canadians believe that physicians have malpractice insurance via the Canadian Medical Protective Association (CMPA). However, the CMPA is not an insurance company; it is a defence fund for physicians and has no obligation to compensate all claimants. CMPA expenses have increased nearly tenfold in 30 years and although public budgets support the majority of CMPA fees, less than 0.3% of injured patients receive compensation. A reform of the system is vital. Several developed countries have adopted a "no-fault" system to provide more equity and transparency and to ensure that the majority of funds go directly to injured patients rather than toward the payment of legal and administrative fees.


Assuntos
Imperícia , Médicos , Canadá , Humanos , Seguro de Responsabilidade Civil
11.
Br J Anaesth ; 127(3): 470-478, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34238547

RESUMO

BACKGROUND: Communication amongst team members is critical to providing safe, effective medical care. We investigated the role of communication failures in patient injury using the Anesthesia Closed Claims Project database. METHODS: Claims associated with surgical/procedural and obstetric anaesthesia and postoperative pain management for adverse events from 2004 or later were included. Communication was defined as transfer of information between two or more parties. Failure was defined as communication that was incomplete, inaccurate, absent, or not timely. We classified root causes of failures as content, audience, purpose, or occasion with inter-rater reliability assessed by kappa. Claims with communication failures contributing to injury (injury-related communication failures; n=389) were compared with claims without any communication failures (n=521) using Fisher's exact test, t-test, or Mann-Whitney U-tests. RESULTS: At least one communication failure contributing to patient injury occurred in 43% (n=389) out of 910 claims (κ=0.885). Patients in claims with injury-related communication failures were similar to patients in claims without failures, except that failures were more common in outpatient settings (34% vs 26%; P=0.004). Fifty-two claims had multiple communication failures for a total of 446 injury-related failures, and 47% of failures occurred during surgery, 28% preoperatively, and 23% postoperatively. Content failures (insufficient, inaccurate, or no information transmitted) accounted for 60% of the 446 communication failures. CONCLUSIONS: Communication failure contributed to patient injury in 43% of anaesthesia malpractice claims. Patient/case characteristics in claims with communication failures were similar to those without failures, except that failures were more common in outpatient settings.


Assuntos
Analgesia/efeitos adversos , Anestesia/efeitos adversos , Comunicação Interdisciplinar , Imperícia , Erros Médicos , Equipe de Assistência ao Paciente , Relações Médico-Paciente , Relações Profissional-Família , Adulto , Idoso , Anestesia Obstétrica/efeitos adversos , Bases de Dados Factuais , Feminino , Humanos , Seguro de Responsabilidade Civil , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Medição de Risco , Fatores de Risco , Análise de Causa Fundamental
15.
Anesth Analg ; 132(3): 890-898, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32665466

RESUMO

In the mid-1980s, the anesthesia departments at hospitals affiliated with Harvard Medical School were faced with a challenge: mounting medical malpractice costs. Malpractice insurance was provided by the Controlled Risk Insurance Company (CRICO), a patient safety and medical malpractice insurance company owned by and providing service to the Harvard medical community. CRICO spearheaded an effort to reduce these costs and ultimately found a way to decrease the risks associated with anesthesia. Here, we chronicle events that led to the dramatic changes in medical practice that resulted from the activities of a small group of concerned anesthesiologists at Harvard-affiliated hospitals. We place these events in a historical perspective and explore how other specialties followed this example, and end with current strategies that minimize the risk associated with anesthesia. We conducted interviews with principals who formulated original standards of patient monitoring. In addition, we consulted documents in the public domain and primary source material. Efforts of these pioneers resulted in the establishment of the seminal Harvard-based anesthesia monitoring standards for minimal monitoring. What followed was an unprecedented transformation of the entire field. After the implementation of these standards at Harvard-affiliated hospitals, the American Society of Anesthesiologists (ASA) adopted "Standards for Basic Anesthetic Monitoring" for use during the administration of all anesthetics in the United States. Other nations have since adopted similar guidelines and these practices have resulted in significant improvements in patient safety. Currently, we estimate mortality due to anesthesia in healthy patients to be 1:400,000-perhaps as much as 10 times lower since the early 1980s. What began as an attempt to lower medical malpractice costs in a group of university hospitals became a worldwide effort that resulted in improvements in patient safety. Other specialties have adopted similar measures. Currently, an attitude and appreciation of safety are exemplified by several practices that include among others-the adherence to these patient safety guidelines, simulator training, the promulgation of standards and guidelines by ASA, and the use of a safety checklist before induction of anesthesia.


Assuntos
Serviço Hospitalar de Anestesia/normas , Anestesia/normas , Anestesiologistas/normas , Monitorização Intraoperatória/normas , Padrões de Prática Médica/normas , Anestesia/efeitos adversos , Anestesia/história , Serviço Hospitalar de Anestesia/história , Anestesiologistas/história , Boston , Fidelidade a Diretrizes/normas , História do Século XX , História do Século XXI , Humanos , Seguro de Responsabilidade Civil , Imperícia , Monitorização Intraoperatória/história , Segurança do Paciente/normas , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/história , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Medição de Risco , Fatores de Risco
17.
Actas Dermosifiliogr (Engl Ed) ; 112(2): 127-133, 2021 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33035496

RESUMO

Teledermatology is now fully incorporated into our clinical practice. However, after reviewing current legislation on the ethical aspects of teledermatology (data confidentiality, quality of care, patient autonomy, and privacy) as well as insurance and professional responsibility, we observed that a specific regulatory framework is still lacking and related legal aspects are still at a preliminary stage of development. Safeguarding confidentiality and patient autonomy and ensuring secure storage and transfer of data are essential aspects of telemedicine. One of the main topics of debate has been the responsibilities of the physicians involved in the process, with the concept of designating a single responsible clinician emerging as a determining factor in the allocation of responsibility in this setting. A specific legal and regulatory framework must be put in place to ensure the safe practice of teledermatology for medical professionals and their patients.


Assuntos
Confidencialidade , Dermatologia , Telemedicina , COVID-19/epidemiologia , Segurança Computacional/ética , Segurança Computacional/legislação & jurisprudência , Confidencialidade/ética , Confidencialidade/legislação & jurisprudência , Dermatologia/ética , Dermatologia/legislação & jurisprudência , Emergências , União Europeia , Humanos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Seguro de Responsabilidade Civil/legislação & jurisprudência , Pandemias , Autonomia Pessoal , SARS-CoV-2 , Espanha , Telemedicina/ética , Telemedicina/legislação & jurisprudência
19.
Tex Med ; 116(8): 38-40, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866276

RESUMO

Under Texas law, physicians treating COVID-19 patients in a volunteer capacity have potential defenses against lawsuits that might arise from that care. But for non-volunteer physicians on the COVID battlefield - often working in harrowing, overloaded settings, high on patient count and low on equipment - the same liability shields don't exist. And with a resurgence in COVID-19 cases and hospitalizations taking hold in June, the Texas Medical Association continued its pandemic-long push to extend liability protections to all frontline physicians, volunteer or not.


Assuntos
Infecções por Coronavirus , Responsabilidade Legal , Pandemias , Administração dos Cuidados ao Paciente , Médicos , Pneumonia Viral , Betacoronavirus , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Humanos , Seguro de Responsabilidade Civil/legislação & jurisprudência , Determinação de Necessidades de Cuidados de Saúde , Administração dos Cuidados ao Paciente/ética , Administração dos Cuidados ao Paciente/legislação & jurisprudência , Administração dos Cuidados ao Paciente/métodos , Médicos/ética , Médicos/legislação & jurisprudência , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , SARS-CoV-2 , Texas/epidemiologia , Voluntários/legislação & jurisprudência
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