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诉讼与舌神经

Litigation and the lingual nerve.

作者信息

Lydiatt Daniel D

机构信息

Head and Neck Surgical Oncology, Department of Otolaryngology, University of Nebraska Medical Center, Omaha, NE 68198, USA.

出版信息

J Oral Maxillofac Surg. 2003 Feb;61(2):197-200; discussion 200. doi: 10.1053/joms.2003.50036.

Abstract

PURPOSE

A "malpractice crisis" exists in the United States. Litigation analysis helps to understand the causes and may be useful in prevention of suits. This study reviews litigation regarding the lingual nerve.

MATERIALS AND METHODS

Jury verdict reports were obtained from a computerized legal database for the years 1987 through 2000. The study reviews all state and federal civil trials in the United States. Reviews compile information on plaintiffs and defendants, allegations of wrong-doing, reasons for litigation, anatomic sites of injuries, specialties of expert witnesses, verdict results, and awards received.

RESULTS

Thirty-three suits from 12 states were obtained. Dentists or oral surgeons were involved in 87%, and otolaryngologists were involved in 13% of suits. Tooth extractions were involved in 79%, and 50% of these resulted in financial awards. Lack of informed consent was alleged in 52% of suits overall and in 46% of tooth extraction suits. Expert witnesses were of the same specialty for both sides in 81%. Inadequate training and selection of the wrong surgical approach were alleged in 18% and 15%, respectively. Anatomic variations were thought to be present in 15%.

CONCLUSIONS

Surgeons must be aware of anatomic variations and regions in which injury to the lingual nerve frequently occurs. Written informed consent may help decrease litigation in known risk regions.

摘要

目的

美国存在“医疗事故危机”。诉讼分析有助于了解其成因,并可能对预防诉讼有用。本研究回顾了有关舌神经的诉讼。

材料与方法

从一个计算机化法律数据库获取了1987年至2000年的陪审团裁决报告。该研究回顾了美国所有州和联邦的民事审判。回顾整理了有关原告和被告、不当行为指控、诉讼原因、损伤的解剖部位、专家证人的专业、裁决结果以及所获赔偿等信息。

结果

获得了来自12个州的33起诉讼。87%的诉讼涉及牙医或口腔外科医生,13%涉及耳鼻喉科医生。79%的诉讼涉及拔牙,其中50%导致了经济赔偿。总体而言,52%的诉讼指控缺乏知情同意,拔牙诉讼中这一比例为

46%。81%的诉讼中双方专家证人专业相同。分别有18%和15%的诉讼指控培训不足和选择了错误的手术入路。15%的诉讼认为存在解剖变异。

结论

外科医生必须了解解剖变异以及舌神经易受损的区域。书面知情同意可能有助于减少已知风险区域的诉讼。

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