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医学纪律法学在放射科医疗事故中的应用:荷兰 10 年经验。

Medical disciplinary jurisprudence in alleged malpractice in radiology: 10-year Dutch experience.

机构信息

Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, The Netherlands.

Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

出版信息

Eur Radiol. 2020 Jun;30(6):3507-3515. doi: 10.1007/s00330-020-06685-0. Epub 2020 Feb 17.

Abstract

PURPOSE

To systematically investigate the frequency and types of allegations related to radiology practice handled by the Dutch Medical Disciplinary Court in the past 10 years.

METHODS

The Dutch Medical Disciplinary Court database was searched for verdicts concerning radiology practice between 2010 and 2019. The association between the number of verdicts and time (years) was assessed by Spearman's rho. Other data were summarized using descriptive statistics.

RESULTS

There were 48 verdicts (mean 4.8 per year). There was no significant association between the number of verdicts and time (Spearman's rho < 0.001, p = 0.99). Most allegations were in breast imaging and musculoskeletal radiology (each 18.8%), followed by interventional radiology, head and neck imaging, and abdominal imaging (each 12.5%), neuroradiology and vascular imaging (each 10.4%), and chest imaging (4.2%). There were 46 allegations against radiologists (95.8%) and 2 against residents (4.2%). The most common allegation (37.5%) was error in diagnosis. In 20.8% of verdicts, the allegation was judged (partially) founded; disciplinary measures were warnings (n = 8) and reprimands (n = 2). An appeal was submitted by the patient in 11 cases and by the radiologist in 3 cases. All appeals by patients were rejected, whereas 2 of the 3 appeals by radiologists were granted and previously imposed disciplinary measures were reversed.

CONCLUSION

Allegations against radiologists at the Dutch Medical Disciplinary Court are relatively few, their number has remained stable over the past 10 years, and a minority were judged to be (partially) founded. We can learn from the cases presented in this article, which may improve patient care.

KEY POINTS

• The frequency of allegations against radiologists at the Dutch Medical Disciplinary Court is relatively low and has not exhibited any temporal change over the past 10 years. • These allegations reflect patient dissatisfaction, but this infrequently equals malpractice. • Knowledge of the circumstances under which these allegations have arisen may improve patient care.

摘要

目的

系统调查过去 10 年荷兰医疗纪律法庭处理的与放射科实践相关的指控频率和类型。

方法

在 2010 年至 2019 年间,搜索荷兰医疗纪律法庭数据库中有关放射科实践的判决。通过斯皮尔曼等级相关系数评估判决数量与时间(年)之间的关联。使用描述性统计对其他数据进行总结。

结果

共有 48 项判决(平均每年 4.8 项)。判决数量与时间之间没有显著关联(斯皮尔曼等级相关系数<0.001,p=0.99)。大多数指控涉及乳房成像和肌肉骨骼放射学(各占 18.8%),其次是介入放射学、头颈部成像和腹部成像(各占 12.5%)、神经放射学和血管成像(各占 10.4%)以及胸部成像(占 4.2%)。有 46 项指控针对放射科医生(95.8%),2 项指控针对住院医师(4.2%)。最常见的指控(37.5%)是诊断错误。在 20.8%的判决中,指控被判定(部分)成立;纪律处分包括警告(n=8)和训斥(n=2)。11 起案件的患者提出上诉,3 起案件的放射科医生提出上诉。所有患者的上诉均被驳回,而放射科医生的 3 项上诉中有 2 项被驳回,先前实施的纪律处分被撤销。

结论

荷兰医疗纪律法庭对放射科医生的指控相对较少,在过去 10 年中数量保持稳定,少数被判定(部分)成立。我们可以从本文介绍的案例中吸取教训,这可能有助于改善患者护理。

关键点

  1. 荷兰医疗纪律法庭对放射科医生的指控频率相对较低,在过去 10 年中没有任何时间变化。

  2. 这些指控反映了患者的不满,但这并不等同于医疗事故。

  3. 了解这些指控产生的情况可能会改善患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fd9/7248030/3e06006113db/330_2020_6685_Fig1_HTML.jpg

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