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急诊科睾丸扭转的处理:从医疗专业责任索赔中吸取的教训。

Management of testicular torsion in the ER: lessons learned from medical professional liability claims.

机构信息

Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain.

Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain; Área de Praxis, Servicio de Responsabilidad Profesional, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, Spain; Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

Actas Urol Esp (Engl Ed). 2021 Jun;45(5):391-397. doi: 10.1016/j.acuroe.2021.04.001. Epub 2021 May 14.

Abstract

OBJECTIVE

To evaluate emergency care for testicular torsion (TT) in medical professional liability (MPL) claims.

METHODS

Claims related to TT from 2000 to 2018 were located. The assistance provided and the association with MPL were analyzed.

RESULTS

Eighty complaints were identified, testicular pain was reported in 83.75% of first consultations, with a mean evolution time of 15.5 h. The mean time to diagnosis was 7.98 days. The first consultation was at the hospital in 75.1% of cases, but an ultrasound was performed only in 7.5%. When TT diagnosis was performed, 97.3% had undergone ancillary tests. The MPL was significantly associated with non-criminal proceedings and with less than 6 h of symptoms' evolution, and, within this subgroup, without undergoing an ultrasound scan.

CONCLUSIONS

Late consultations, wrong diagnosis and late diagnosis are claimed. When MPL are claimed by means of non-criminal law, the existence of responsibility is frequently considered, even more in those cases when the consultation took place before 6 h of evolution with no ancillary tests having been performed.

摘要

目的

评估医疗专业责任(MPL)索赔中睾丸扭转(TT)的急救护理。

方法

定位了 2000 年至 2018 年与 TT 相关的索赔。分析了提供的援助和与 MPL 的关系。

结果

共确定了 80 份投诉,83.75%的首次就诊报告了睾丸疼痛,平均演变时间为 15.5 小时。平均诊断时间为 7.98 天。75.1%的病例在医院进行首次就诊,但仅进行了 7.5%的超声检查。当进行 TT 诊断时,97.3%的患者进行了辅助检查。MPL 与非刑事诉讼和症状演变不到 6 小时显著相关,并且在该亚组中,没有进行超声检查。

结论

存在延迟就诊、误诊和延迟诊断的情况。当通过非刑法提出 MPL 索赔时,经常会认为存在责任,在症状演变不到 6 小时且没有进行辅助检查的情况下就诊,这种情况更为常见。

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