Lee Kyeong-Seok, Shim Jae-Jun, Shim Jae-Hyun, Oh Jae-Sang, Yoon Seok-Mann
Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
J Korean Neurosurg Soc. 2018 Jul;61(4):474-477. doi: 10.3340/jkns.2017.0404.012. Epub 2018 Apr 10.
From November 30, 2016, the Korean Government carried the revised Medical Dispute Mediation and Arbitration Act into effect. Mediation will start automatically without agreements of the defendant, when the outcome of the patient was death, coma more than a month or severe disability. Cerebral aneurysm has a definite risk of bad outcome, especially in the worst condition. Any surgical intervention to this lesion has its own high risk of complications. Recently, Seoul central district court decided 50% responsibility of the doctors who made a rupture of the aneurysm during coiling (2015Ga-Dan5243104). We reviewed judicial precedents related to cerebral aneurysms in lawsuit using a web search.
We searched judicial precedents at a web search of the Supreme Court, using the key words, "cerebral aneurysm".
There were 15 precedents, six from the Supreme Court, seven from the High Court, and two from district courts. Seven precedents were related to the causation analysis, such as work-relationship. Five precedents were malpractice suits related bad results or complications. Remaining three precedents were related to the insurance payment. In five malpractice precedents, two precedents of the Supreme Court reversed former two precedents of the High Court.
Judicial precedents on the cerebral aneurysm included not only malpractice suits, but also causation analysis or insurance payment. Attention to these subjects is needed. We also need education of the independent medical examination. To avoid medical disputes, shared decision making seems to be useful, especially in cases of high risk condition or procedures.
自2016年11月30日起,韩国政府实施修订后的《医疗纠纷调解与仲裁法》。当患者死亡、昏迷超过一个月或严重残疾时,调解将在未经被告同意的情况下自动启动。脑动脉瘤有明确的不良预后风险,尤其是在最严重的情况下。对该病变进行的任何手术干预都有其自身较高的并发症风险。最近,首尔中央地方法院判定在动脉瘤栓塞过程中导致动脉瘤破裂的医生承担50%的责任(2015Ga-Dan5243104)。我们通过网络搜索回顾了诉讼中与脑动脉瘤相关的司法判例。
我们在最高法院的网络搜索中,使用关键词“脑动脉瘤”搜索司法判例。
共有15个判例,其中6个来自最高法院,7个来自高等法院,2个来自地方法院。7个判例与因果关系分析有关,如工作关系。5个判例是与不良结果或并发症相关的医疗事故诉讼。其余3个判例与保险赔付有关。在5个医疗事故判例中,最高法院的2个判例推翻了高等法院先前的2个判例。
关于脑动脉瘤的司法判例不仅包括医疗事故诉讼,还包括因果关系分析或保险赔付。需要关注这些主题。我们还需要独立医学检查方面的教育。为避免医疗纠纷,共同决策似乎很有用,尤其是在高风险情况或手术中。