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睡眠手术与医疗事故。

Sleep surgery and medical malpractice.

机构信息

Department of Otolaryngology, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.

出版信息

Laryngoscope. 2014 Jun;124(6):E250-4. doi: 10.1002/lary.24559. Epub 2014 Jan 17.

Abstract

OBJECTIVES/HYPOTHESIS: To describe and analyze the causes and outcomes of lawsuits pertaining to sleep surgery to mitigate future litigation and improve physician education.

STUDY DESIGN

A retrospective review of a publicly available database containing jury verdicts and settlements.

METHODS

The LexisNexis MEGA Jury Verdicts and Settlements database was reviewed for all lawsuits including settlements and trial verdicts related to sleep surgery. Data including type of surgery performed, plaintiff allegation, nature of injury, outcomes, and indemnities were collected and analyzed.

RESULTS

Fifty-one cases met the inclusion criteria. Of these, 30 were decided by a jury, nine were settled out of court, and 10 were resolved by other means. Overall, 57% of known outcomes favored the defendant. The most common surgery performed was tonsillectomy (57%), followed by uvulopalatopharyngoplasty (45%), adenoidectomy (31%), and septoplasty (31%). No difference was found between outcomes when comparing the most common injuries cited, including wrongful death (P = .572), airway compromise (P = .376), and drug reaction (P = .443). If failure to recognize a complication (P = .034) or delay in diagnosis (P = .026) was a component of the legal allegations, the outcome significantly favored the plaintiff. The median settlement ($545,000) and plaintiff award ($1.45 million) were not significantly different (P = .13).

CONCLUSIONS

The majority of outcomes favored the defendant. Type of injury did not predict outcome. Failure to recognize complications and delay in diagnosis strongly predicted a verdict in favor of the plaintiff.

LEVEL OF EVIDENCE

2c.

摘要

目的/假设:描述和分析与睡眠手术相关的诉讼的原因和结果,以减轻未来的诉讼并改善医生教育。

研究设计

对一个公开可用的包含陪审团裁决和和解的数据库进行回顾性审查。

方法

审查 LexisNexis MEGA 陪审团裁决和和解数据库,以获取与睡眠手术相关的所有诉讼,包括和解和审判裁决。收集和分析的数据包括所进行的手术类型、原告指控、伤害性质、结果和赔偿。

结果

符合纳入标准的病例有 51 例。其中,30 例由陪审团裁决,9 例庭外和解,10 例通过其他方式解决。总的来说,57%的已知结果对被告有利。最常见的手术是扁桃体切除术(57%),其次是悬雍垂腭咽成形术(45%)、腺样体切除术(31%)和鼻中隔成形术(31%)。在比较引用的最常见损伤时,没有发现结果有差异,包括不当死亡(P = .572)、气道阻塞(P = .376)和药物反应(P = .443)。如果未能识别并发症(P = .034)或延迟诊断(P = .026)是法律指控的一部分,那么结果显著有利于原告。和解的中位数($545,000)和判给原告的赔偿金($1.45 百万)没有显著差异(P = .13)。

结论

大多数结果对被告有利。损伤类型不能预测结果。未能识别并发症和延迟诊断强烈预示着有利于原告的裁决。

证据水平

2c。

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