Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
Am J Otolaryngol. 2013 Nov-Dec;34(6):699-705. doi: 10.1016/j.amjoto.2012.12.005. Epub 2013 Jan 16.
Medicolegal factors contribute to increasing healthcare costs through the direct costs of malpractice litigation, malpractice insurance premiums, and defensive medicine. Malpractice litigation trends are constantly changing as a result of technological innovations and changes in laws. In this study, we examine the most recent legal decisions related to Otolaryngology and characterize the factors responsible for determining legal responsibility.
The Westlaw legal database (Thomson Reuters, New York, NY) was used to search for jury verdicts since 2008 in Otolaryngology malpractice cases. The 44 cases included in this analysis were studied to determine the procedures most commonly litigated and progressing to trial, as well as the year, location, alleged cause of malpractice, specialty of co-defendants, and case outcomes.
Out of the 44 cases included in this analysis, physicians were not found liable in 36 (81.8%) cases. Rhinologic procedures comprised 38.6% of cases litigated, and rulings were in physicians' favor in 66.7% of endoscopic sinus surgery (ESS) cases and all non-ESS rhinologic cases. A perceived lack of informed consent was noted in 34.1% of cases. The 8 jury awards averaged $940,000 (range, $148,000-$3,600,000).
Otolaryngologists were not found liable in the majority of cases reviewed. Rhinologic surgeries were the most common procedures resulting in litigation. Adenotonsillectomies, thyroidectomies, and airway management are also well-represented. Perceived deficits in informed consent and misdiagnosis were noted in a considerable proportion of otolaryngologic malpractice cases resulting in jury decisions.
医疗事故法因素通过医疗事故诉讼的直接成本、医疗事故保险费和防御性医疗导致医疗保健费用增加。由于技术创新和法律的变化，医疗事故诉讼趋势不断变化。在这项研究中，我们研究了与耳鼻喉科相关的最新法律判决，并确定了导致法律责任的因素。
使用 Westlaw 法律数据库（Thomson Reuters，纽约，NY）搜索自 2008 年以来耳鼻喉科医疗事故案件的陪审团裁决。对包括在本分析中的 44 个案例进行研究，以确定最常进行诉讼和进入审判程序的程序，以及年份、地点、被指控的医疗事故原因、共同被告的专业和案件结果。
在包括在本分析中的 44 个案例中，36 例（81.8%）未发现医生有责任。进行诉讼的案例中 38.6%为鼻科学程序，在鼻内镜鼻窦手术（ESS）案例中，66.7%的裁决对医生有利，所有非 ESS 鼻科学案例均对医生有利。在 34.1%的案例中注意到缺乏知情同意。8 项陪审团裁决的平均金额为 94 万美元（范围为 14.8 万美元至 360 万美元）。
在审查的大多数案例中，耳鼻喉科医生没有被判定有责任。鼻科学手术是导致诉讼的最常见程序。腺样体扁桃体切除术、甲状腺切除术和气道管理也有很好的代表性。在导致陪审团裁决的相当一部分耳鼻喉科医疗事故案例中，注意到了知情同意和误诊的缺陷。
