[股骨骨骺滑脱的诊断与治疗中的医疗过失]
[Malpractice in the diagnosis and treatment of the slipped capital femoral epiphysis].
作者信息
Püschmann H, Vinz H, Neu J
机构信息
Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Arztekammern, Hannover.
出版信息
Z Orthop Unfall. 2008 Nov-Dec;146(6):710-4. doi: 10.1055/s-2008-1039089. Epub 2008 Dec 12.
INTRODUCTION
Expert commissions (Gutachterkommissionen) and arbitration offices (Schlichtungsstellen) in Germany are expert panels for the extrajudical resolution of malpractice claims. The performance of arbitration panel proceedings ("Schlichtungsverfahren") is based on the German medical and insurance jurisdiction.
METHOD
39 arbitration panel proceedings concerning supposed malpractice in the diagnosis and treatment of slipped capital femoral epiphysis were evaluated in regard to the involved clinics and physicians and, respectively, the medical specialties, type of slippage (acute or chronic), malpractice and the disabilities caused by malpractice.
RESULTS
In 28 cases (72 %) the malpractice was confirmed, the average of confirmed failures in all proceedings being about 30 %. The failures could be classified as misdiagnosis followed by inadequate treatment and failures in operative treatment. Minor and moderate permanent disabilities due to malpractice remained in 8 cases, severe permanent disability resulted in 14 cases due to osteonecrosis of the femoral head.
DISCUSSION
The results are discussed with regard to the avoidance of mistakes in diagnosis and treatment and the problems of medical assessment.
引言
德国的专家委员会（鉴定委员会）和仲裁机构（调解机构）是用于庭外解决医疗事故索赔的专家小组。仲裁小组程序（“调解程序”）的执行基于德国的医疗和保险管辖权。
方法
对39例关于股骨骨骺滑脱诊断和治疗中疑似医疗事故的仲裁小组程序进行了评估，涉及相关诊所和医生，以及医学专业、滑脱类型（急性或慢性）、医疗事故和医疗事故导致的残疾情况。
结果
28例（72%）医疗事故得到确认，所有程序中确认的失误平均约为30%。失误可分为误诊后治疗不当以及手术治疗失误。8例因医疗事故导致轻度和中度永久性残疾，14例因股骨头坏死导致严重永久性残疾。
讨论
就避免诊断和治疗失误以及医疗评估问题对结果进行了讨论。
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