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涉及下消化道内镜检查的医疗纠纷:来自韩国医疗纠纷调解与仲裁机构的案例

Medical disputes involving lower gastrointestinal endoscopies: cases from the Korean Medical Dispute Mediation and Arbitration Agency.

作者信息

Oh Eun Hye, Shin Jeong Eun, Bae Jun Yong, Lee Yoon Suk, Park Yehyun, Kwon Yong Hwan, Paik Chang Nyol, Lee Jun Kyu, Lee Tae Hee

机构信息

Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.

出版信息

Korean J Intern Med. 2025 May;40(3):404-426. doi: 10.3904/kjim.2024.343. Epub 2025 Apr 30.

Abstract

BACKGROUND/AIMS: As the number of lower gastrointestinal endoscopies and high-risk examinees increases, the incidence of adverse events associated with these endoscopies has also increased. Medical disputes and lawsuits related to adverse events are rapidly increasing.

METHODS

Medical disputes related to lower gastrointestinal endoscopy that had been filed in Korean Medical Dispute Mediation and Arbitration Agency (K-medi) from April 2012 to August 2020 were evaluated with the corresponding medical records and written appraisal. Facilities, patients, procedures, adverse events, and outcome-related variables related to medical disputes were analyzed.

RESULTS

As the number of lower gastrointestinal endoscopies in Korea increases each year, the number of medical disputes related to lower gastrointestinal endoscopy appraised by K-medi has also increased yearly during the same period. Among the 121 cases analyzed, 86 (71.1%) were conciliated and 35 (28.9%) were cosigned by prosecution. Perforations accounted for the largest proportion of cases (93 cases, 76.9%). Most patients (n = 119, 98.3%) underwent non-emergent procedures, and only 10 (8.3%) underwent them for therapeutic purposes. Approximately one-fifth of the patients (n = 25, 20.7%) died.

CONCLUSION

The number of medical disputes related to lower gastrointestinal endoscopy are increasing. To prevent this, it is important to review the data on existing cases and establish specific response guidelines.

摘要

背景/目的:随着下消化道内镜检查数量以及高风险受检者数量的增加,与这些内镜检查相关的不良事件发生率也有所上升。与不良事件相关的医疗纠纷和诉讼正在迅速增加。

方法

对2012年4月至2020年8月期间向韩国医疗纠纷调解与仲裁机构(K-medi)提交的与下消化道内镜检查相关的医疗纠纷进行评估,并查阅相应的病历和书面鉴定。分析与医疗纠纷相关的机构、患者、操作、不良事件以及与结果相关的变量。

结果

随着韩国每年下消化道内镜检查数量的增加,同期K-medi评估的与下消化道内镜检查相关的医疗纠纷数量也逐年增加。在分析的121例病例中,86例(71.1%)达成调解,35例(28.9%)被起诉。穿孔病例占比最大(93例,76.9%)。大多数患者(n = 119,98.3%)接受的是非紧急操作,只有10例(8.3%)是出于治疗目的进行操作。约五分之一的患者(n = 25,20.7%)死亡。

结论

与下消化道内镜检查相关的医疗纠纷数量正在增加。为预防此事,审查现有病例数据并制定具体应对指南很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4b7/12081107/711624025519/kjim-2024-343f1.jpg

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