日本与胃肠内镜检查相关的医疗事故诉讼：民事法庭案件的二十年回顾
Medical malpractice litigation related to gastrointestinal endoscopy in Japan: a two-decade review of civil court cases.
作者信息
Hiyama Toru, Tanaka Shinji, Yoshihara Masaharu, Fukuhara Tatsuma, Mukai Shinichi, Chayama Kazuaki
机构信息
Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan.
出版信息
World J Gastroenterol. 2006 Nov 14;12(42):6857-60. doi: 10.3748/wjg.v12.i42.6857.
AIM
To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan.
METHODS
A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken.
RESULTS
Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to esophagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%).
CONCLUSION
These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.
目的
调查日本与胃肠内镜检查相关的医疗事故诉讼中的指控情况。
方法
对1985年至2005年这21年间在民事法院系统审理的案件进行回顾性研究，这些案件来自一个计算机化的法律数据库。
结果
共确定了18起医疗事故诉讼及30项指控。在这18起（44%）医疗事故诉讼中，8起（44%）与食管胃十二指肠镜检查有关，4起（22%）与结肠镜检查有关，4起（22%）与内镜括约肌切开术有关，2起（11%）与内镜逆行胰胆管造影有关。17起（94%）案件涉及并发症，其余1起（6%）案件涉及误诊。10例患者死于并发症。指控分为：（1）内镜操作过程中的操作失误（n = 12，40%）；（2）缺乏知情同意（n = 9，30%）；（3）内镜操作后治疗过程中的操作失误（n = 4，13%）；（4）术前用药失误（n = 3，10%）；（5）诊断失误（n = 1，3%）；（6）内镜操作的适应症错误（n = 1，3%）。
结论
这些数据可能有助于胃肠内镜医师设计风险预防策略。
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