Bordonaba-Leiva Sergio, Gómez-Durán Esperanza L, Balibrea José M, Benet-Travé Josep, Martin-Fumadó Carles, Bescos Atin Coro, Mareque-Bueno Javier, Arimany-Manso Josep
Department of Oral and Maxillofacial Surgery, Germans Trias i Pujol University Hospital; Universitat Autònoma de Barcelona, Barcelona, Spain.
Area de Praxi, Col-legi de Metges de Barcelona, Passeig Bonanova, 47, 08017, Barcelona, Spain.
Oral Maxillofac Surg. 2019 Jun;23(2):187-192. doi: 10.1007/s10006-019-00756-3. Epub 2019 Apr 29.
Oral and maxillofacial surgery (OMS) malpractice risk is of special interest due to both the aesthetic component of some procedures and the complexity of the pathologies involved. This study aims to identify relevant factors involved in OMS professional liability (PL) claims to help achive better management of risks and improve patient safety.
We performed a retrospective analysis of 315 OMS claims opened between 1990 and 2014 from the database of the PL Department of the Catalonian Council of Medical Colleges, and identified their clinical, economical and juridical characteristics.
OMS showed a high rate of compensation (33.8%). Dental implant surgery, third molar surgery and rhinoplasty presented the greatest exposure to claims, and in these cases, lack of osteointegration of dental implants, neurologic injury of inferior dentoalveolar/lingual nerves and a poor aesthetic result were the most frequently compensated sequelae. Statistically, significant association was found between this perioperative complications group and the presence of PL. Poorly documented patient information (informed consent document) was also significantly related with PL outcome.
OMS is a specialty of medium risk for claims, especially oral surgery cases. Surgical complications, such as neurologic damage after oral/head and neck procedures and poor aesthetic results, do occur and deserve special attention to improve patient safety, as well as patient-information procedure.
由于某些手术的美学因素以及所涉及病理情况的复杂性，口腔颌面外科（OMS）的医疗事故风险备受关注。本研究旨在确定口腔颌面外科职业责任（PL）索赔中涉及的相关因素，以帮助更好地管理风险并提高患者安全性。
我们对加泰罗尼亚医学院PL部门数据库中1990年至2014年间受理的315起口腔颌面外科索赔进行了回顾性分析，并确定了它们的临床、经济和法律特征。
口腔颌面外科显示出较高的赔偿率（33.8%）。种植牙手术、第三磨牙手术和隆鼻手术面临的索赔风险最高，在这些病例中，种植牙缺乏骨整合、下牙槽/舌神经神经损伤以及美学效果不佳是最常获得赔偿的后遗症。从统计学角度来看，这一围手术期并发症组与职业责任的存在之间存在显著关联。记录不充分的患者信息（知情同意文件）也与职业责任结果显著相关。
口腔颌面外科是索赔风险中等的专业领域，尤其是口腔外科病例。手术并发症，如口腔/头颈部手术后的神经损伤和美学效果不佳确实会发生，值得特别关注以提高患者安全性以及患者信息程序。
