Campbell W B, France F, Goodwin H M
Vascular Surgical Society of Great Britain and Ireland, Royal College of Surgeons of England, London, UK.
Ann R Coll Surg Engl. 2002 May;84(3):181-4.
Knowledge about medicolegal claims is important for risk management and clinical practice. This study presents the first comprehensive collated data for vascular surgical practice.
Details of claims notified to the National Health Service Litigation Authority (NHSLA) since its inception in 1995, and to the Medical Defence Union (MDU) from 1990-1999 were analysed.
A total of 424 claims were notified--170 NHSLA and 254 MDU (176 from surgeons who described themselves as 'vascular' and 248 from 'general surgeons'). Varicose veins were the commonest condition involved (244 claims) and nerve damage was the most frequent complaint (76), followed by incorrect or unsatisfactory surgery (35), and damage to the femoral vein (16) or artery (13). Arterial claims (174) against vascular surgeons comprised 88% in the NHS but only 39% in private practice: 45 related to aortic grafting, 28 to other bypass grafts, and 36 alleged failure to recognise or treat ischaemia.
The likely cause of many of these claims was failure to advise patients about potential risks and expected benefits. Recognition of the areas of highest risk, with improvements in communication and record keeping, may limit future claims.
了解医疗法律索赔对于风险管理和临床实践至关重要。本研究提供了血管外科实践的首个综合整理数据。
分析了自1995年成立以来向国民医疗服务诉讼管理局（NHSLA）通报的索赔详情，以及1990 - 1999年向医疗保护联盟（MDU）通报的索赔详情。
共通报了424起索赔——170起向NHSLA通报，254起向MDU通报（176起来自自称“血管外科医生”的外科医生，248起来自“普通外科医生”）。静脉曲张是涉及的最常见病症（244起索赔），神经损伤是最常见的投诉（76起），其次是手术不正确或不令人满意（35起），以及股静脉（16起）或动脉（13起）损伤。针对血管外科医生的动脉索赔（174起）在国民医疗服务中占88%，但在私人执业中仅占39%：45起与主动脉移植有关，28起与其他搭桥移植有关，36起指称未能识别或治疗缺血。
这些索赔中许多的可能原因是未向患者告知潜在风险和预期益处。认识到最高风险领域，改善沟通和记录保存，可能会减少未来的索赔。
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