Angiò L G, Ventura Spagnolo E, Pirrone G, Cardia G
Universita degli Studi di Messina, Italy.
G Chir. 2011 Mar;32(3):153-8.
The Authors focus on the liability of the surgery team members in the case they inadvertently forget behind in the patient's body a foreign object, which causes injuries and/or death. The Authors underline that, according to the current case law regarding medical malpractice, both the main surgeon and their assistant/subordinate are liable for engaging in a markedly imprudent and/or negligent conduct, such as not double-checking scrupulously the surgical site before its closure in order to highlight forgotten foreign bodies. As well, the Authors underline that either the circulator nurse or the theatre nurse can be considered punishable by law when that medical error occurs, even if they are responsible for the count of the instruments used in the course of the surgery. Conversely, the main surgeon and his or her assistant are always directly responsible, due to the fact that the nurses' count procedure represents merely an additional control measure, without substituting at all the check the surgeons must obligatory conduct on the surgical site. Finally, the Authors point out that, as the count procedure is performed by the members of a surgical team, where a hierarchy-based relationship rules, the main surgeon is the liable for any preventable and avoidable adverse event provoked by the nursing staff as a consequence of the objective responsibility due to culpa in eligendo and culpa in vigilando.
作者关注手术团队成员在无意中将异物遗留在患者体内并导致伤害和/或死亡的情况下应承担的责任。作者强调，根据现行关于医疗事故的判例法，主刀医生及其助手/下属都应对明显轻率和/或疏忽的行为负责，比如在关闭手术切口前没有仔细再次检查手术部位以发现遗留的异物。同样，作者强调，当发生这种医疗差错时，巡回护士或器械护士即使负责手术过程中所用器械的清点，也可能会被依法惩处。相反，主刀医生及其助手始终直接负责，因为护士的清点程序仅仅是一种额外的控制措施，根本不能替代外科医生必须在手术部位进行的检查。最后，作者指出，由于清点程序是由手术团队成员执行的，而手术团队中存在基于等级的关系，主刀医生应对护理人员因选任过失和监管过失导致的客观责任所引发的任何可预防和可避免的不良事件负责。
