Park Bo Young, Kim Min Ji, Kang So Ra, Hong Seung Eun
Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Ann Surg Treat Res. 2016 Dec;91(6):316-322. doi: 10.4174/astr.2016.91.6.316. Epub 2016 Nov 25.
Currently, development of pulmonary thromboembolism (PTE) after surgery is frequently being followed by legal action in Korea, as consequences may be fatal. In the current study, we assessed possible countermeasures that medical teams can take when faced with conflicting opinions on responsibility for PTE.
A retrospective analysis of claims handled by the Supreme Court and subordinate courts, from 1999 to 2015, was performed. We analyzed the type of procedure, associated complications, and critical legal points from the recorded judgments along with any liability limitations on surgeons.
After reviewing cases between 1999 and 2015, a total of 18 cases were analyzed. There were no cases in which the surgeon was held accountable between 1999 and 2002. From 2003, there were instances of the surgeon being held accountable, with a peak of cases in 2013. Legal standards applied in judicial decision-making related to appropriate use of preventive measures, operation characteristics, doctor's reaction towards symptom occurrence, obligation of postoperative medical care, and duty of explanation.
The courts in Korea have changed their position from one of denying doctors' liability to one of enforcing responsibility for PTE. Surgeons are therefore being held responsible with greater frequency, depending on the details of the case. Lessons can be learnt from precedents that can be incorporated into medical education and training programs with the aim of reducing both major PTE complication rates and litigation costs.
目前,在韩国,手术后发生肺血栓栓塞症(PTE)常常引发法律诉讼,因为其后果可能是致命的。在本研究中,我们评估了医疗团队在面对关于PTE责任的相互冲突意见时可以采取的可能对策。
对1999年至2015年最高法院及下属法院处理的索赔案件进行回顾性分析。我们分析了手术类型、相关并发症、记录判决中的关键法律要点以及对外科医生的任何责任限制。
在审查了1999年至2015年的病例后,共分析了18例。1999年至2002年期间没有外科医生被追究责任的案例。从2003年起,有外科医生被追究责任的情况,2013年案例数量达到峰值。司法决策中适用的法律标准涉及预防措施的适当使用、手术特点、医生对症状出现的反应、术后医疗护理义务以及解释责任。
韩国法院已从否认医生责任的立场转变为对PTE追究责任的立场。因此,根据案件细节,外科医生被追究责任的频率更高。可以从前例中吸取教训,并将其纳入医学教育和培训项目,以降低主要PTE并发症发生率和诉讼成本。