Breitenfelder J
Orthopädischen Klinik, St. Vincenz-Hospitals, Brakel/Westfalen.
Z Orthop Ihre Grenzgeb. 1993 Jan-Feb;131(1):6-9. doi: 10.1055/s-2008-1039895.
Causes of proven medical misconduct were analyzed on the basis of 142 expert testimonies prepared for an advisory committee on medical liability. The principal causes of misconduct identified were: 1. an incorrect indication for surgery; 2. Unsatisfactory surgical technique; 3. Inadequate preoperative patient enlightenment. In many of the cases in which an incorrect indication for therapy or a technical error could not be proved, the patients or their lawyers attempted to assert their claims by declaring that they had been insufficiently informed. The majority of the claims for recourse concerned: a) problems associated with implantation of total hip replacements; b) sequelae of revisional osteotomies of the lower extremity; c) infiltration therapy with a topical anesthetic; d) sequelae of lumbar disc surgery. These four therapeutic categories accounted for almost two-thirds of all proven errors of therapy and in informing patients. A total of 16.26% of the claims were resolved in the plaintiff's favor. Several examples are presented to illustrate the problem of incorrect indication and unsatisfactory surgical technique as a cause of proven therapeutic error.
根据为一个医疗责任咨询委员会准备的142份专家证词，对已证实的医疗不当行为的原因进行了分析。所确定的不当行为的主要原因是：1. 手术指征错误；2. 手术技术不令人满意；3. 术前对患者的告知不足。在许多无法证明治疗指征错误或技术失误的案例中，患者或其律师试图通过宣称他们没有得到充分告知来主张自己的权利。大多数索赔涉及：a）全髋关节置换植入相关问题；b）下肢翻修截骨术的后遗症；c）局部麻醉浸润治疗；d）腰椎间盘手术的后遗症。这四类治疗占所有已证实的治疗错误和告知患者错误的近三分之二。共有16.26%的索赔以原告胜诉告终。文中给出了几个例子来说明手术指征错误和手术技术不令人满意作为已证实的治疗错误原因的问题。
