Chadwick H S, Posner K, Caplan R A, Ward R J, Cheney F W
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
Anesthesiology. 1991 Feb;74(2):242-9. doi: 10.1097/00000542-199102000-00009.
Malpractice claims filed against anesthesiologists for care involving obstetric (OB) anesthesia (n = 190) were taken from the American Society of Anesthesiologists' Closed Claims Database and compared to claims not involving OB cases (n = 1351). The most common complications in the OB claims were (percentage of all OB claims): maternal death (22%), newborn brain damage (20%), and headache (12%). In contrast, the most common complications in the nonobstetric (non-OB) group were (percentage of all non-OB claims): death (39%), nerve damage (16%), and brain damage (13%). The group of OB claims contained a proportionately greater number of minor injuries, such as headache, backache, pain during anesthesia, and emotional injury (32%) compared to the non-OB claims (4%). Complications due to aspiration and convulsions were more common among the OB cases. The standard of care was judged to have been met in 46% of OB and 39% of non-OB claims. This difference is not statistically significant. Claims involving general anesthesia were more frequently associated with severe injuries and resulted in higher payments than did claims involving regional anesthesia. Payments were made in a similar proportion of OB and non-OB claims (53 and 59%, respectively). For cases in which payments were made, the median payment for OB claims was significantly greater ($203,000) than for non-OB claims ($85,000; P less than or equal to 0.05).
针对麻醉医生在产科麻醉护理方面提出的医疗事故索赔（n = 190）取自美国麻醉医师协会的封闭索赔数据库，并与不涉及产科病例的索赔（n = 1351）进行比较。产科索赔中最常见的并发症为（占所有产科索赔的百分比）：产妇死亡（22%）、新生儿脑损伤（20%）和头痛（12%）。相比之下，非产科组最常见的并发症为（占所有非产科索赔的百分比）：死亡（39%）、神经损伤（16%）和脑损伤（13%）。与非产科索赔（4%）相比，产科索赔组中轻伤的比例相对较高，如头痛、背痛、麻醉期间疼痛和精神损伤（32%）。误吸和惊厥导致的并发症在产科病例中更为常见。46%的产科索赔和39%的非产科索赔被判定符合护理标准。这种差异无统计学意义。与区域麻醉相关的索赔相比，涉及全身麻醉的索赔更常与重伤相关，且赔付金额更高。产科和非产科索赔获得赔付的比例相似（分别为53%和59%）。对于已赔付的病例，产科索赔的赔付中位数（203,000美元）显著高于非产科索赔（85,000美元；P≤0.05）。
