Helms L B, Helms C M
Department of Internal Medicine, University of Iowa College of Medicine, General Hospital, Iowa City 52242.
Acad Med. 1991 Dec;66(12):718-25. doi: 10.1097/00001888-199112000-00002.
The authors reviewed 136 cases of malpractice litigation involving residents or programs of graduate medical education that were reported from 1950 through 1989. Before 1970 malpractice constituted the only area of reported litigation for residents. The number of malpractice cases involving residents increased substantially after 1975, paralleling the growth of malpractice cases nationally. The regional pattern of reported cases involving residents also corresponded with previous findings. Questions of vicarious liability, the applicable standard of care, and residents' supervision were at issue in the great majority of cases. Questions related to judicial procedure, immunity from liability, breach or causation, and informed consent were also litigated. Residents were on the side of the prevailing party in 44% of the cases. Malpractice continues to be the key legal issue facing programs of residency training.
作者回顾了1950年至1989年期间报告的136起涉及住院医师或毕业后医学教育项目的医疗事故诉讼案件。1970年以前,医疗事故是报告的住院医师诉讼的唯一领域。1975年以后,涉及住院医师的医疗事故案件数量大幅增加,与全国医疗事故案件的增长情况平行。报告的涉及住院医师案件的区域模式也与先前的研究结果相符。在绝大多数案件中,替代责任问题、适用的护理标准问题以及住院医师的监督问题都存在争议。与司法程序、责任豁免、违约或因果关系以及知情同意相关的问题也进行了诉讼。在44%的案件中,住院医师站在胜诉方一边。医疗事故仍然是住院医师培训项目面临的关键法律问题。