Kiuchi A, Nosaka S, Amakata Y, Yoshiya I, Nishi K
Department of Anesthesiology, Nissei Hospital, Nippon Life Saiseikai Foundation, Osaka.
Masui. 1999 May;48(5):487-99.
We reviewed 75 judicial precedents on anesthetic malpractice during surgical procedure which had appeared in legal journals in the period between 1963 and 1997. Anesthetic techniques employed were: general anesthesia (35 cases), spinal anesthesia (19 cases), local anesthesia (12 cases), and others (9 cases). Anesthesiologists were involved in 16 lawsuits, of which anesthesiologists lost 6 suits between 1986 and 1995. There were 8 cases classified as to be caused by respiratory problems including 2 cases of wrong gas supply. The defendants lost all the 8 cases. On the other hand, the plaintiff lost all the cases of malignant hyperthermia (n = 7). There is a tendency of increase in law suit with general anesthesia. Recent judgments suggested the importance of anesthetic managements, correct recording and appropriate monitoring by anesthesiologist during and immediately after surgery. Spinal anesthesia should be performed by anesthesiologist, and the frequency of anesthetic accident should be decreased. Japan is still in short of anesthesiologists and efforts should be paid to increase the number of anesthesia specialists.
我们回顾了1963年至1997年间发表在法律期刊上的75例外科手术麻醉失误的司法判例。所采用的麻醉技术包括：全身麻醉（35例）、脊髓麻醉（19例）、局部麻醉（12例）以及其他（9例）。麻醉医生涉及16起诉讼，其中在1986年至1995年间，麻醉医生败诉6起。有8例被归类为因呼吸问题导致，其中包括2例气体供应错误。被告在这8起案件中全部败诉。另一方面，原告在所有恶性高热案件（n = 7）中均败诉。全身麻醉引发诉讼有增加的趋势。近期的判决表明麻醉管理、麻醉医生在手术期间及术后即刻进行正确记录和适当监测的重要性。脊髓麻醉应由麻醉医生实施，并且应降低麻醉事故的发生率。日本麻醉医生仍然短缺，应努力增加麻醉专科医生的数量。
