Wu Kuan-Han, Wu Chien-Hung, Cheng Shih-Yu, Lee Wen-Huei, Kung Chia-Te
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung County 833, Taiwan.
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung County 833, Taiwan.
Am J Emerg Med. 2014 Sep;32(9):990-6. doi: 10.1016/j.ajem.2014.05.033. Epub 2014 Jun 2.
The objective of the study is to examine the epidemiologic data of closed malpractice medical claims against emergency departments (EDs) in Taiwanese civil courts and to identify high-risk diseases.
We conducted a retrospective study and reviewed the verdicts from the national database of the Taiwan judicial system that pertained to EDs. Between 2003 and 2012, a total of 63 closed medical claims were included.
Seven cases (11.1%) resulted in an indemnity payment, 55.6% of the cases were closed in the district court, but appeals were made to the supreme court in 12 cases (19.1%). The mean incident-to-litigation closure time was 57.7 ± 26.8 months. Of the cases with indemnity paid, 5 cases (71.4%) were deceased, and 2 cases (28.6%) were gravely injured. All cases with indemnity paid were determined to be negligent by a medical appraisal. The gravely injured patients had more indemnity paid than deceased patients ($299800 ± 37000 vs $68700 ± 29300). The most common medical conditions involved were infectious diseases (27.0%), central nervous system bleeding (15.9%), and trauma cases (12.7%). It was also found that 71.4% of the allegations forming the basis of the lawsuit were diagnosis related.
Emergency physicians (EPs) in Taiwan have similar medico-legal risk as American EPs, with an annual risk of being sued of 0.63%. Almost 90% of EPs win their cases but spend 58 months in litigation, and the mean indemnity payment was $134738. Cases with indemnity paid were mostly categorized as having diagnosis errors, with the leading cause of error as failure to order an appropriate diagnostic test.
本研究的目的是审查台湾民事法庭中针对急诊科（ED）的已结案医疗事故索赔的流行病学数据，并识别高风险疾病。
我们进行了一项回顾性研究，并审查了台湾司法系统国家数据库中与急诊科相关的判决。2003年至2012年期间，共纳入63例已结案的医疗索赔。
7例（11.1%）导致了赔偿支付，55.6%的案件在地区法院结案，但有12例（19.1%）向最高法院提起了上诉。从事件发生到诉讼结案的平均时间为57.7±26.8个月。在已支付赔偿的案件中，5例（71.4%）患者死亡，2例（28.6%）患者受重伤。所有已支付赔偿的案件经医学鉴定均被判定存在过失。受重伤患者的赔偿支付高于死亡患者（299800±37000美元对68700±29300美元）。涉及的最常见医疗状况为传染病（27.0%）、中枢神经系统出血（15.9%）和创伤病例（12.7%）。还发现，构成诉讼基础的指控中有71.4%与诊断相关。
台湾急诊科医生（EP）面临的医疗法律风险与美国急诊科医生相似，每年被起诉的风险为0.63%。几乎90%的急诊科医生胜诉，但诉讼时间长达58个月，平均赔偿金额为134738美元。已支付赔偿的案件大多被归类为存在诊断错误，错误的主要原因是未安排适当的诊断检查。
