Bernasinski M, Lepousé C, Bankole E, Rouche O, Milloncourt L, Leon A
Centre hospitalier universitaire de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
Ann Fr Anesth Reanim. 2012 Mar;31(3):191-5. doi: 10.1016/j.annfar.2011.12.013. Epub 2012 Feb 27.
Dental injuries are among the most common complications of general anesthesia. Yet few studies have assessed the costs and factors that involve the responsibility of the anesthetist.
A retrospective study was conducted at the university hospital of Reims on 46 cases of dental injuries directly related to anaesthesia.
Ten patients made a claim for compensation. Two of them have received compensation following a medical expertise, which revealed for the first patient a possible alternative to general anaesthesia, and the second, hardware failure of intubation. The Administrative Court was entered once in 9 years. The global insurance-cost amounts to 4476 euros for all patients. The review of all cases of anaesthesia shows clearly that the dental claims are associated with a significant under clinical evaluation of dental status and criteria for difficult intubation during the anaesthesia. The information to the patient on this risk is not obvious from reading the anaesthesia records. No mouth guard was used.
This work proves that the statements of caution are the most common and a minority of dental trauma lead to a claim. Claims are due to the high cost of dental care repair. The proportion of patients receiving benefits is extremely low. Medical expertise is an essential part of the evaluation of medical responsibilities. No compensation was paid without expertise. The lack of physical examination and information are contrary to our professional obligations and may involve our responsibility. The lack of patient information is not generated for compensation to the extent that the consequences of failure are easily dental weighed against the benefits of the entire medical-surgical procedure that the patient has agreed.
牙齿损伤是全身麻醉最常见的并发症之一。然而,很少有研究评估涉及麻醉师责任的成本和因素。
在兰斯大学医院对46例与麻醉直接相关的牙齿损伤病例进行了回顾性研究。
10名患者提出了赔偿要求。其中两名患者在医学鉴定后获得了赔偿,鉴定结果显示,第一名患者可能存在全身麻醉的替代方案,第二名患者则是插管硬件故障。行政法院9年受理了一次此类案件。所有患者的全球保险费用总计4476欧元。对所有麻醉病例的审查清楚地表明,牙齿损伤索赔与麻醉期间对牙齿状况和困难插管标准的临床评估严重不足有关。从麻醉记录中看,向患者告知这种风险并不明显。未使用口腔防护器。
这项研究证明,警示声明最为常见,少数牙齿创伤会导致索赔。索赔是由于牙齿护理修复成本高昂。获得赔偿的患者比例极低。医学鉴定是评估医疗责任的重要组成部分。未经鉴定不支付任何赔偿。缺乏体格检查和信息告知违背了我们的职业义务,可能会让我们承担责任。未向患者提供信息并不是为了获得赔偿,因为失误的后果很容易与患者同意的整个医疗手术程序的益处进行权衡。