Fileni A, Magnavita N
Istituti di Radiologia, Università Cattolica del Sacro Cuore, Roma.
Radiol Med. 1998 May;95(5):506-10.
The insurance claims against Italian radiologists over a five-year period (1993-97) were anonymously evaluated, based on pertinent data provided by the Insurance Company of the Italian Society of Medical Radiology.
The database analyzed represents over one third of Italian radiologists. A total number of 171 insurance claims were analyzed and classified by cause as due to: 1) misidiagnosis; 2) alleged malpractice when performing the examination; 3) missed referral to other diagnostic/therapeutic procedures; 4) iatrogenic lesions by ionizing/nonionizing radiations; 5) patient's injury occurring during the examination; 6) lawsuits after the Italian Code of Criminal Procedure (art. 589) in case of patient's death (although not directly related to the radiologist's work).
In the first three-year period, the rate of claims was 25.8 per thousand persons/year. Each Italian radiologist has a 90% risk of being sied by a patient once in his/her professional life (35 years). Alleged malpractice accounted for more than 75% of the claims. Misdiagnosis represented the first and most important claims category (43.9% of total). The most common misdiagnoses were the failure to diagnose lesions affecting bones and joints, chest, abdomen and breast. The second most important claim category (20.5%) was complications, frequently occurring during interventional procedures and contrast media injection. Fewer claims (7.6%) originated from patient's injury occurring in the radiology department during the execution of the examination. Finally, radiologists were frequently sved together with medical (or surgical) doctors in case of patient's death, according to the Italian Code of Criminal Procedure.
Legal claims against radiologists are a relevant phenomenon also in our country and represent an actual risk for radiologists' professional activity.
根据意大利医学放射学会保险公司提供的相关数据,对五年期间(1993 - 1997年)针对意大利放射科医生的保险索赔进行了匿名评估。
所分析的数据库涵盖了超过三分之一的意大利放射科医生。共分析了171起保险索赔,并按原因分类如下:1)误诊;2)检查过程中被指控的医疗失误;3)未及时转诊至其他诊断/治疗程序;4)电离/非电离辐射导致的医源性损伤;5)检查过程中患者受伤;6)根据意大利刑事诉讼法(第589条),在患者死亡情况下的诉讼(尽管与放射科医生的工作无直接关联)。
在头三年期间,索赔率为每年每千人25.8起。每位意大利放射科医生在其职业生涯(35年)中有90%的风险会被患者起诉一次。被指控的医疗失误占索赔的75%以上。误诊是首要且最重要的索赔类别(占总数的43.9%)。最常见的误诊是未能诊断出影响骨骼和关节、胸部、腹部及乳腺的病变。第二重要的索赔类别(20.5%)是并发症,常在介入操作和注射造影剂过程中频繁发生。较少的索赔(7.6%)源于检查执行过程中放射科内患者受伤。最后,根据意大利刑事诉讼法,在患者死亡的情况下,放射科医生经常与内科(或外科)医生一起被起诉。
在我国,针对放射科医生的法律索赔也是一个重要现象,对放射科医生的专业活动构成实际风险。