Poyorena Christopher, Anderson Aimee, Pollock Jordan R, Homme James L, Rappaport Douglas E, Shufeldt John, Lindor Rachel A
Mayo Clinic Alix School of Medicine Scottsdale Arizona USA.
Arizona State University Phoenix Arizona USA.
J Am Coll Emerg Physicians Open. 2023 Aug 1;4(4):e13014. doi: 10.1002/emp2.13014. eCollection 2023 Aug.
This study characterizes medical malpractice lawsuits involving trainees providing care in the emergency department (ED), affording insight into the types of patients involved, clinical scenarios, and legal outcomes of these cases.
Cases were identified using the legal database, Westlaw. Per chart review methods, relevant information was abstracted by 2 trained reviewers onto a standardized data abstraction form, with a senior author arbitrating disagreements.
We identified 60 cases reported between 1982 and 2017 in which a trainee was named in a lawsuit related to patient care provided in the ED. The most common alleged errors included diagnostic ( = 37, 61%), treatment ( = 13, 21%), and procedural errors ( = 19, 16%). In 21 cases (35%), it was alleged that no attending physician was directly involved in the care at any time. The attending was noted to have seen the patient in person at any point in only 11 total cases (18%). Of the 50 cases with known outcomes, 15 (30%) decided in favor of the patient, 21 (42%) were resolved in the physician's favor, and 14 (28%) were settled.
This study underscores that trainees are vulnerable to malpractice cases and that lack of direct supervision is a prominent theme in these cases. This information suggests areas for further work and may help training programs, trainees, and supervising physicians design their practice patterns in ways that mitigate these risks in the future.
本研究对涉及在急诊科（ED）提供护理的实习生的医疗事故诉讼进行了特征描述，以深入了解所涉及患者的类型、临床场景以及这些案件的法律结果。
使用法律数据库Westlaw识别案件。根据病历审查方法，由2名经过培训的审查人员将相关信息摘要到标准化的数据摘要表格上，由一位资深作者对分歧进行仲裁。
我们确定了1982年至2017年间报告的60起案件，其中一名实习生被起诉与在急诊科提供的患者护理有关。最常见的被指控错误包括诊断（n = 37，61%）、治疗（n = 13，21%）和程序错误（n = 19，16%）。在21起案件（35%）中，据称没有主治医生在任何时候直接参与护理。仅在总共11起案件（18%）中，记录到主治医生在任何时候亲自看过患者。在50起已知结果的案件中，15起（30%）判决有利于患者，21起（42%）以医生胜诉解决，14起（28%）达成和解。
本研究强调实习生容易面临医疗事故案件，并且缺乏直接监督是这些案件中的一个突出主题。这些信息表明了进一步工作的领域，并可能有助于培训项目、实习生和指导医生以降低未来这些风险的方式设计他们的执业模式。
