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超越手术室:审视身体塑形手术中的法律责任。

Beyond the operating room: a look at legal liability in body contouring procedures.

机构信息

Department of Surgery, Division of Plastic Surgery, New Jersey Medical School, Rutgers University, Newark, New Jersey.

出版信息

Aesthet Surg J. 2014 Jan 1;34(1):106-13. doi: 10.1177/1090820X13513459. Epub 2013 Nov 20.

Abstract

BACKGROUND

Malpractice claims affect the cost and quality of health care.

OBJECTIVE

In this study, the authors examine legal litigation following body contouring surgery and identify factors influencing malpractice litigation outcomes.

METHODS

The Westlaw legal database was searched for jury verdict and settlement reports related to body contouring procedures and medical malpractice. Cases included for analysis were examined for year of report, geographic location, patient demographics, procedure performed, alleged injury, causes of action, verdict, and indemnity payments.

RESULTS

Of 113 cases, the most common injuries sustained were disfigurement (33.6%) and the necessitation of a revision procedure (33.6%). The most common cause of action cited was negligence (84.1%). Median plaintiff ages differed significantly (P = .003) between cases favoring the defendant (44.5 years) and those favoring the plaintiff (36 years). Of the alleged injuries, those cases citing an iatrogenic injury were 2.5 times more likely to result in either damages awarded or settlement (relative risk [RR], 2.5; 95% confidence interval [CI], 1.66-3.80). Cases that cited disfigurement were 87% more likely to result in damages awarded to the plaintiff (RR, 1.87; 95% CI, 1.08-3.26).

CONCLUSIONS

Based on this study of body contouring litigation, younger plaintiff age and iatrogenic injury strongly favored plaintiffs in either awarded damages or a settlement. Disfigurement favored plaintiffs only in awarded damages. Our study emphasizes the need for adequate communication with the patient explaining realistic aesthetic results and risks of the procedure. In addition, iatrogenic organ injury must be handled expeditiously. Incorporating these recommendations into clinical practice may promote an improved physician-patient relationship while reducing litigatious health care costs.

摘要

背景

医疗事故索赔会影响医疗保健的成本和质量。

目的

本研究旨在审查身体整形手术后的法律诉讼,并确定影响医疗事故诉讼结果的因素。

方法

在 Westlaw 法律数据库中搜索与身体整形手术和医疗事故相关的陪审团裁决和和解报告。对纳入分析的案例进行了报告年份、地理位置、患者人口统计学、手术类型、损伤类型、诉讼原因、裁决和赔偿金额的分析。

结果

在 113 例案例中,最常见的损伤是毁容(33.6%)和需要进行修复手术(33.6%)。最常见的诉讼原因是过失(84.1%)。支持被告的案例中,原告的平均年龄(44.5 岁)与支持原告的案例(36 岁)之间存在显著差异(P=0.003)。在所指控的损伤中,那些因医源性损伤而被起诉的案例,无论是判给损害赔偿金还是和解,其可能性都高出 2.5 倍(相对风险[RR],2.5;95%置信区间[CI],1.66-3.80)。那些指控毁容的案例,判给原告损害赔偿金的可能性高出 87%(RR,1.87;95%CI,1.08-3.26)。

结论

根据本项关于身体整形手术诉讼的研究,年轻的原告年龄和医源性损伤对原告无论是判给损害赔偿金还是和解都有很大的帮助。毁容仅有利于判给原告损害赔偿金。本研究强调了与患者进行充分沟通的必要性,以解释手术的现实美学效果和风险。此外,医源性器官损伤必须迅速处理。将这些建议纳入临床实践中,可能会促进改善医患关系,同时降低医疗保健的诉讼成本。

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