Aïssou M, Lemesle D, Abbas S, Lienhart A
Service d'anesthésie-réanimation, hôpital Saint-Antoine, université Paris-VI, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Ann Fr Anesth Reanim. 2012 May;31(5):447-53. doi: 10.1016/j.annfar.2012.01.028. Epub 2012 Mar 31.
All the files of complications of regional anaesthesias requiring an expertise for a Regional Commission for Conciliation and Compensation for medical accidents (CRCI) between 2003 and 2008 were analyzed. The objective was to estimate the homogeneity of the appointed experts, their opinions and the opinions of the CRCI. Querying the database, shared by the National Office for Compensation for Medical Accidents (ONIAM) and the CRCI, and identified 40 files corresponding to the selection criteria. The expertise carried out involved an anaesthetist in 27 cases, always registered, either on the national list of the experts in medical accidents, or on one list of court-appointed experts. Conversely, in 13 cases, no specialist performing himself the technique in question was involved in the expertise, and sometimes the expert was registered on any list. Mostly, the non-specialists do not conclude to medical malpractice. This was not the case in a single file, where the anaesthetist sought and obtained the addition of an anaesthetist in a new expertise, which concluded differently. Damages assessed were highly variable, but the given evidence provided to understand why. The CRCI have generally followed the opinions of the experts, except in a few cases where the evidence allowed a different opinion without requiring a new expertise. In conclusion, the abnormalities in the appointment of experts do not seem to have had consequences in terms of damage assessment, but may alter the balance between causes faulty and not faulty, in favour of the latter.
对2003年至2008年间需要医疗事故调解与赔偿区域委员会（CRCI）专业知识的区域麻醉并发症的所有文件进行了分析。目的是评估指定专家的同质性、他们的意见以及CRCI的意见。查询由国家医疗事故赔偿办公室（ONIAM）和CRCI共享的数据库，确定了40份符合选择标准的文件。所进行的专业鉴定在27例中涉及一名麻醉师，该麻醉师始终在国家医疗事故专家名单或法院指定专家名单上登记。相反，在13例中，进行相关技术操作的专科医生未参与专业鉴定，有时专家未在任何名单上登记。大多数情况下，非专科医生未认定存在医疗过失。在一个案例中情况并非如此，该案例中麻醉师寻求并在新的专业鉴定中增加了一名麻醉师，而后者得出了不同的结论。评估的损害差异很大，但所提供的证据有助于理解原因。CRCI通常遵循专家的意见，除了少数情况下证据允许有不同意见且无需进行新的专业鉴定。总之，专家任命方面的异常情况似乎在损害评估方面没有产生影响，但可能会改变有过错原因和无过错原因之间的平衡，有利于后者。
