Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Langenbecks Arch Surg. 2021 Sep;406(6):2053-2057. doi: 10.1007/s00423-020-02069-6. Epub 2021 Jan 8.
Pediatric surgeons treat a vulnerable population in which unfavorable outcome can lead to substantial long-term costs, placing them at risk for malpractice claims. This study aims to characterize the frequency and circumstances in which malpractice claims were successfully brought against pediatric surgeons in Germany over the last 5 years.
Anonymous data on medical treatment errors and payments were acquired from the Federal Chamber of Physicians from 2014 through 2018 and analyzed for most frequent diagnoses and circumstances that resulted in accusation or conviction. Those claims that were successfully rebutted were compared to as controls. Lifetime risk for being involved in litigation and its outcome was calculated.
There were 129 medical malpractice claims over the 5-year observation period. Medical error was confirmed in 56 cases (43%); the rest were successfully appealed. The risk of the prototypical German pediatric surgeon to be accused was 5.24% and to be convicted 2.27% per year in practice. The most common reasons for conviction (alone or in combination) were surgical-technical errors (23%), treatment delay (21%), insufficient workup (17%), incorrect diagnosis (17%), and incomplete consent (16%).The most frequent circumstances leading to a conviction were trauma (27%), inguinal hernia (7%), circumcision (7%), testicular torsion (7%), acute abdomen (7%), and appendicitis (5%).
Over a 40-year career, pediatric surgeons in Germany face an average calculated risk of 2.1 to be accused and 0.9 to be convicted of malpractice claims. Certain circumstances pose higher risks for litigation than others. Knowledge of these patterns may help practitioners avoid medicolegal confrontation.
小儿外科医生治疗的是弱势群体，如果治疗结果不佳，可能会导致巨大的长期费用，使他们面临医疗事故索赔的风险。本研究旨在描述过去 5 年内德国小儿外科医生成功提起医疗事故索赔的频率和情况。
从 2014 年至 2018 年，我们从联邦医师协会获得了关于医疗失误和赔偿的匿名数据，并对导致指控或定罪的最常见诊断和情况进行了分析。将那些成功反驳的索赔与对照组进行比较。计算了一生中参与诉讼及其结果的风险。
在 5 年的观察期内，有 129 起医疗事故索赔。56 例（43%）确认存在医疗差错；其余的都成功上诉。典型的德国小儿外科医生每年在实践中被指控的风险为 5.24%，被定罪的风险为 2.27%。定罪的最常见原因（单独或组合）是手术技术错误（23%）、治疗延误（21%）、检查不充分（17%）、诊断错误（17%）和同意书不完整（16%）。导致定罪的最常见情况是创伤（27%）、腹股沟疝（7%）、包皮环切术（7%）、睾丸扭转（7%）、急性腹痛（7%）和阑尾炎（5%）。
在 40 年的职业生涯中，德国小儿外科医生平均面临 2.1%的被指控风险和 0.9%的被定罪风险。某些情况下，诉讼风险高于其他情况。了解这些模式可能有助于医生避免医疗法律纠纷。
