Bruguera Miquel, Delgado Salvadora, Viger Mercè, Benet Josep, Bruguera Roger, Arimany Josep
Unitat d'Estudis Acadèmics del Collegi de Metges de Barcelona.
Cir Esp. 2012 Apr;90(4):254-9. doi: 10.1016/j.ciresp.2011.12.003. Epub 2012 Mar 8.
To analyse the causes for claims due to alleged malpractice in bariatric surgery and the results of the legal process.
A review was carried out on the case files of claims for damages as a result of bariatric surgery presented to the Professional Liability Department of the Catalonian Medical Colleges Council from 1992 to 2009. The claims rate was calculated using a survey of bariatric surgeons.
A total of 49 cases were analysed, which represented 0.6% of the patients operated on. The patient died in 23 (47%) of the cases, 14% were left with serious after effects, 18% had mild after effects, and 21% made a complete recovery. The most frequent causes of death were peritonitis due to suture dehiscence (48%), and respiratory complications (17.4%). Retrospectively, malpractice was considered to have occurred in 10 (20%) of the sued cases due to lack of an adequate informed consent document, delay in recognising a complication, or an error in interpretation, or treatment of the complication. The doctor sued was convicted in 10 of the cases, 3 in a criminal court, and 7 in a civil court. There was acquittal in 19 cases, an out-of court settlement with payment of compensation in 4, withdrawal of the claim in 4, and judgement or sentence is still pending in 12 cases.
The study showed a relatively low rate of claims for complications associated with bariatric surgery. The number of convictions was relatively high. The early detection of surgical complications is essential in order to reduce legal claims associated with bariatric surgery.
分析因肥胖症手术涉嫌医疗事故而引发索赔的原因及法律程序的结果。
对1992年至2009年提交给加泰罗尼亚医学院理事会职业责任部门的因肥胖症手术导致损害索赔的病例档案进行了审查。索赔率通过对肥胖症外科医生的调查来计算。
共分析了49例病例，占接受手术患者的0.6%。其中23例（47%）患者死亡，14%留有严重后遗症，18%有轻度后遗症，21%完全康复。最常见的死亡原因是缝合处裂开导致的腹膜炎（48%）和呼吸并发症（17.4%）。回顾性分析发现，在被起诉的病例中有10例（20%）被认为存在医疗事故，原因包括缺乏充分的知情同意文件、并发症识别延迟、并发症解释或治疗错误。被起诉的医生在10例案件中被定罪，3例在刑事法庭，7例在民事法庭。19例案件被宣告无罪，4例庭外和解并支付了赔偿金，4例撤诉，12例案件的判决或宣判仍在等待中。
该研究表明，与肥胖症手术相关的并发症索赔率相对较低。定罪数量相对较高。早期发现手术并发症对于减少与肥胖症手术相关的法律索赔至关重要。
