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涉及经皮冠状动脉介入和外周介入的医疗事故诉讼。

Medical Malpractice Lawsuits Involving Percutaneous Coronary and Peripheral Intervention.

作者信息

Kirshteyn Gabrielle, Golan Roei, Gilchrist Ian C, Cohen Mauricio G

机构信息

Florida State University College of Medicine, Tallahassee, Florida.

Cardiology Division, Department of Medicine, Pennsylvania State Heart and Vascular Institute, Hershey, Pennsylvania.

出版信息

J Soc Cardiovasc Angiogr Interv. 2023 Apr 21;2(5):100975. doi: 10.1016/j.jscai.2023.100975. eCollection 2023 Sep-Oct.

Abstract

BACKGROUND

Malpractice lawsuits following percutaneous coronary and peripheral interventions are not uncommon. Understanding the most common causes of medical legal action can inform clinicians and prevent future injury and litigation.

METHODS

LexisNexis is a legal database that compiles all publicly available court records for state and federal jury verdicts and settlements in the United States. We analyzed LexisNexis for malpractice cases involving percutaneous coronary and peripheral interventions between January 1, 2005 and December 31, 2020.

RESULTS

We found a total of 89 cases over the studied period, of which 55 cases were coronary interventions, 18 cases were peripheral interventions, and 16 cases did not specify the vessel location. Procedural error was alleged in 44 (49.4%) cases, complications in 42 (47.2%) cases, failure to monitor in 22 (24.7%) cases, failure to properly treat in 15 (16.9%) cases, incorrect treatment in 15 (16.9%) cases, failure to refer in 10 (11.2%) cases, lack of informed consent in 9 (10.1%) cases, and delay of intervention in 3 (3.4%) cases. The most common procedural error was vessel perforation (34.1%). Death was the most prevalent precipitating medical outcome of the cases (n = 41, 46.1%). Litigation resolution favored the defendant in 43 (48.3%) cases, the plaintiff in 13 (14.6%) cases, and a settlement was reached in 33 (37.1%) cases.

CONCLUSIONS

Awareness of the most common causes of litigations among interventional cardiologists and vascular specialists may prevent future legal actions and promote implementations of processes to improve patient care. Our results suggest the importance of attentive patient care before, during, and after percutaneous coronary and peripheral interventions. Procedural expectations and risks should be meticulously discussed with patients and families.

摘要

背景

经皮冠状动脉介入治疗和外周介入治疗后发生的医疗事故诉讼并不罕见。了解医疗法律诉讼的最常见原因可为临床医生提供参考,并预防未来的伤害和诉讼。

方法

LexisNexis是一个法律数据库,汇编了美国州和联邦陪审团裁决及和解的所有公开法庭记录。我们分析了LexisNexis中2005年1月1日至2020年12月31日期间涉及经皮冠状动脉介入治疗和外周介入治疗的医疗事故案例。

结果

在研究期间,我们共发现89例案例,其中55例为冠状动脉介入治疗,18例为外周介入治疗,16例未明确血管位置。44例(49.4%)被指控存在操作失误,42例(47.2%)存在并发症,22例(24.7%)存在监测不力,15例(16.9%)存在治疗不当,15例(16.9%)存在治疗错误,10例(11.2%)存在转诊不当,9例(10.1%)存在缺乏知情同意,3例(3.4%)存在干预延迟。最常见的操作失误是血管穿孔(34.1%)。死亡是这些案例中最常见的促发医疗后果(n = 41,46.1%)。诉讼结果在43例(48.3%)中有利于被告,13例(14.6%)中有利于原告,33例(37.1%)达成和解。

结论

介入心脏病学家和血管专家了解诉讼的最常见原因,可能会预防未来的法律诉讼,并促进改进患者护理流程的实施。我们的结果表明,在经皮冠状动脉介入治疗和外周介入治疗之前、期间和之后进行细心的患者护理非常重要。应与患者及其家属仔细讨论操作预期和风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3096/11307492/ea25d24119bd/fx1.jpg

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