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希腊普通外科病例的法医学分析:一项48年的研究

Medico-Legal Analysis of General Surgery Cases in Greece: A 48 Year Study.

作者信息

Tzoumas Lambros, Samara Evangelia, Tzoumas Konstantinos, Tzimas Petros, Vlachos Konstantinos, Papadopoulos Georgios

机构信息

Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University Hospital of Ioannina, Ioannina, GRC.

Department of Anaesthesiology, Onassis Cardiac Surgery Center, Athens, GRC.

出版信息

Cureus. 2021 Jul 6;13(7):e16205. doi: 10.7759/cureus.16205. eCollection 2021 Jul.

Abstract

Introduction Surgery can be dangerous not only for patients, but it also carries a risk for the surgeon in case of medical error, which can affect their future medical career. The purpose of our research is to assess the current situation regarding medical liability in General Surgery in Greece, the reasons for the allegations of medical malpractice as well as the relationship between these issues and the court results. Methods Published court decisions of criminal, civil, administrative and disciplinary content were searched in legal information banks, between year 1973 and 2020. Court decisions were analyzed by an expert, a specialist general surgeon and an anesthesiologist, for the causes of death and the correctness of the court decision in collaboration with the lawyers of the investigation. Results  588 court decisions were retrieved, out if which 103 (17.751%) criminal (n = 81), or civil and administrative decisions (n ​​= 22) for surgeons. Out of a total of 81 first and second instance criminal cases and appellate court decisions of the Supreme Court, 27 cases concerned negligent homicide, 16 cases concerned negligent bodily harm and seven were acquittals. Out of 22 civil cases decisions, awarding or not awarding compensation, three cases concerned negligent homicide, seven bodily harm and two were acquittals. 11 cases of negligent homicide concerned laparoscopic and bariatric surgical procedures. Conclusions Laparoscopic surgery represents one of the most important surgical developments in the last 30 years. However, they represent a great proportion of the cases concerning medical malpractice in the greek legal system. It is important to have a national center for reporting misdiagnosis and complications and a medical liability system that will facilitate improved diagnosis, learning from diagnostic errors and delays in diagnosis, in order to avoid similar cases of malpractice in the future.

摘要

引言

手术不仅对患者有风险,而且在出现医疗差错时,对外科医生也有风险,这可能会影响他们未来的医疗职业生涯。我们研究的目的是评估希腊普通外科医疗责任的现状、医疗事故指控的原因以及这些问题与法庭判决之间的关系。

方法

在法律信息库中检索1973年至2020年期间公布的刑事、民事、行政和纪律处分方面的法庭判决。由一名专家、一名普通外科专科医生和一名麻醉师与调查律师合作,分析法庭判决中关于死亡原因和法庭判决的正确性。

结果

共检索到588份法庭判决,其中103份(17.751%)是针对外科医生的刑事判决(n = 81)或民事和行政判决(n = 22)。在最高法院的81起一审和二审刑事案件及上诉法院判决中,27起案件涉及过失杀人,16起案件涉及过失身体伤害,7起案件无罪释放。在22起民事案件判决中,无论是否判给赔偿,3起案件涉及过失杀人,7起涉及身体伤害,2起无罪释放。11起过失杀人案件涉及腹腔镜手术和减肥手术。

结论

腹腔镜手术是过去30年中最重要的外科进展之一。然而,在希腊法律体系中,它们在医疗事故案件中占很大比例。设立一个全国性的误诊和并发症报告中心以及一个医疗责任体系很重要,这将有助于改善诊断、从诊断错误和诊断延误中吸取教训,以避免未来出现类似的医疗事故案件。

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