Wu King-Jean, Hsieh Sung-Chih, Yang Cheng-Ning, Chen Yi-Wen, Lai Chao-Lun, Lai Ting-Ju, Yen-Ping Kuo Mark
Department of Dentistry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan.
J Dent Sci. 2023 Jan;18(1):374-381. doi: 10.1016/j.jds.2022.11.008. Epub 2022 Nov 23.
BACKGROUND/PURPOSE: Little is known regarding the outcomes and distinguishing characteristics of lawsuits related to endodontic procedures. This study used a verdict-based data from United States of America to analyze the factors associated with endodontic malpractice lawsuits and mitigate the risk of litigation.
The LexisNexis legal database was used to search for endodontic malpractice cases from January 1, 2000 to December 31, 2021 using the terms "medical malpractice" and (I) "endodontist" (II) "endodontics" (III) "root canal" (IV) "dental pulp." Each case was reviewed for reported medical characteristics and litigation outcomes.
A total of 650 cases were initially identified, and 97 cases were included in the final analysis. Eighty-four (86.6%) of the 97 defendants were general practitioners; 42 cases favored the plaintiff, 53 (54.6%) favored the defendant, 1 was partial win/loss, and 1 was settled. The annual case mean was 4.41 ± 2.17 (Mean ± SD). The major allegations favored for the patients involving paresthesia, root perforation, rubber dam not use, wrong tooth therapy, and infections. Plaintiffs who claimed with post-procedural reasons had a significantly higher winning rate than non-post-procedural reasons (P < 0.05).
In the present study, 54.6% of endodontic litigation favored the dentists in the US. The authors recommend that general practitioners refer complicated cases to endodontists and treat carefully to avoid paresthesia, canal perforation and infections. Clinicians should always diagnose and treat correctly, shared decision making with the patient, use rubber dam routinely, and timely management to prevent malpractice claims.
背景/目的:关于牙髓治疗程序相关诉讼的结果和显著特征,人们了解甚少。本研究使用来自美国基于裁决的数据,分析与牙髓医疗事故诉讼相关的因素,并降低诉讼风险。
利用LexisNexis法律数据库,通过搜索词条“医疗事故”以及(I)“牙髓病医生”(II)“牙髓病学”(III)“根管治疗”(IV)“牙髓”,查找2000年1月1日至2021年12月31日期间的牙髓医疗事故案例。对每个案例的报告医疗特征和诉讼结果进行审查。
初步共识别出650个案例,最终分析纳入97个案例。97名被告中的84名(86.6%)为全科医生;42个案例原告胜诉,53个(54.6%)案例被告胜诉,1个案例部分胜负,1个案例和解。年平均案例数为4.41 ± 2.17(均值 ± 标准差)。患者胜诉的主要指控涉及感觉异常、根管穿孔、未使用橡皮障、错牙治疗和感染。以术后原因起诉的原告胜诉率显著高于非术后原因起诉的原告(P < 0.05)。
在本研究中,美国54.6%的牙髓治疗诉讼有利于牙医。作者建议全科医生将复杂病例转诊给牙髓病医生,并谨慎治疗以避免感觉异常、根管穿孔和感染。临床医生应始终正确诊断和治疗,与患者共同决策,常规使用橡皮障,并及时处理以防止医疗事故索赔。