Department of Urology, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA.
J Urol. 2012 Feb;187(2):528-32. doi: 10.1016/j.juro.2011.10.045. Epub 2011 Dec 15.
Medical malpractice indemnity payments continue to rise, resulting in increased insurance premiums. We reviewed closed malpractice claims pertaining to endourological procedures with the goal of helping urologists mitigate their risk of lawsuit.
All closed malpractice claims from 2005 to 2010 pertaining to endourological procedures filed against urologists insured by the Medical Liability Mutual Insurance Company of New York were examined. Claims were reviewed for plaintiff demographics, medical history, operative details, alleged complication, clinical outcome and lawsuit disposition.
A total of 25 closed claims involved endourological operations and of these cases 10 were closed with an indemnity payment. The average payout was $346,722 (range $25,000 to $995,000). Of the plaintiffs 16 were women and mean plaintiff age was 51.4 years. Cystoscopy with ureteral stent placement/exchange resulted in 13 lawsuits, ureteroscopic lithotripsy 8, percutaneous stone extraction 2 and shock wave lithotripsy 2. There were 17 malpractice suits brought for alleged operative complications. Failure to arrange adequate followup was implicated in 4 cases. Error in diagnosis and delay in treatment was alleged in 3 claims.
Urologists are not immune to the current medical malpractice crisis. Endourology and urological oncology generate the greatest number of lawsuits against urologists. Most malpractice claims involving endourological procedures result from urolithiasis and alleged technical errors. Therefore, careful attention to surgical technique is essential during stone procedures to reduce the risk of malpractice litigation.
医疗事故赔偿仍在持续上升，导致保险费不断增加。我们对涉及腔内泌尿外科手术的已决医疗事故索赔进行了回顾性研究，旨在帮助泌尿科医生降低其面临法律诉讼的风险。
对 2005 年至 2010 年期间纽约医疗责任互助保险公司承保的泌尿科医生涉及腔内泌尿外科手术的所有已决医疗事故索赔进行了研究。对原告人口统计学、病史、手术细节、指控的并发症、临床结局和诉讼处理等进行了回顾性分析。
共涉及 25 例已决腔内泌尿外科手术索赔案例，其中 10 例有赔偿支付。平均赔付额为 346722 美元（范围 25000 美元至 995000 美元）。在原告中，16 例为女性，平均年龄为 51.4 岁。因膀胱镜检查伴输尿管支架置入/更换而引发的诉讼有 13 起，输尿管镜碎石术 8 起，经皮肾镜取石术 2 起，体外冲击波碎石术 2 起。有 17 起医疗事故诉讼是因所谓的手术并发症而提起的。有 4 起诉讼涉及未安排足够的随访。3 起诉讼指控存在诊断错误和治疗延误。
泌尿科医生不能幸免于当前的医疗事故危机。腔内泌尿外科和泌尿外科肿瘤学产生了针对泌尿科医生的最大数量的法律诉讼。大多数涉及腔内泌尿外科手术的医疗事故索赔都源于尿石症和所谓的技术错误。因此，在结石处理过程中，应特别注意手术技术，以降低医疗事故诉讼的风险。
