Lydiatt Daniel D, Sewell Ryan K
Division of Head and Neck Surgical Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
Otolaryngol Head Neck Surg. 2008 Nov;139(5):677-81. doi: 10.1016/j.otohns.2008.06.027.
Sinonasal disease is a common diagnosis that is encountered by nearly all specialties. This study examines medical malpractice trends in sinonasal disease.
One hundred fifty-two malpractice cases involving sinonasal disease between 1988 and 2005 were obtained from a computerized legal database.
Defendants prevailed in 62 percent of the cases with a median monetary award of $650,000. Younger patients prevailed at a higher rate than did older patients (50% vs 35%), and men had a higher median award than did women ($1.0 million vs $314,000). These results approached but did not reach statistical significance (P = 0.09, P = 0.06). Otolaryngologists were the most commonly sued specialty (56%). The most common complications of endoscopic sinus surgery included cerebrospinal fluid leak, orbital trauma, and anosmia. Cancer plaintiffs received the highest median award of $1.5 million.
Physicians must be diligent in forming differential diagnoses, and surgeons must ensure informed consent is obtained and documented. Future studies should continue to identify risk management strategies and areas for malpractice reform.
鼻窦疾病是几乎所有专科都会遇到的常见诊断。本研究调查鼻窦疾病中的医疗事故趋势。
从一个计算机化法律数据库中获取了1988年至2005年间152例涉及鼻窦疾病的医疗事故案例。
在62%的案例中被告胜诉，赔偿金额中位数为65万美元。年轻患者胜诉率高于老年患者（50%对35%），男性的赔偿金额中位数高于女性（100万美元对31.4万美元）。这些结果接近但未达到统计学显著性（P = 0.09，P = 0.06）。耳鼻喉科医生是最常被起诉的专科（56%）。鼻内镜手术最常见的并发症包括脑脊液漏、眼眶创伤和嗅觉丧失。癌症原告获得的赔偿金额中位数最高，为150万美元。
医生在进行鉴别诊断时必须勤勉，外科医生必须确保获得并记录知情同意。未来的研究应继续确定风险管理策略和医疗事故改革领域。
