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[运动系统术后感染后报告的医疗事故。261份专家证词评估分析]

[Reported malpractice after postoperative infection of the locomotor system. Analysis of 261 expert testimony evaluations].

作者信息

Müller L, Hansis M

机构信息

Klinik und Poliklinik für Unfallchirurgie, Universität Bonn.

出版信息

Chirurg. 1998 Nov;69(11):1263-9. doi: 10.1007/s001040050566.

Abstract

Postoperative infection in the locomotor system may lead to malpractice suits. The aim of the study was to determine the success rate of these claims and the type of expert-confirmed medical negligence so that strategies for avoiding such negligence can be offered. A total of 261 degrees concerning suspected malpractice after postoperative infection in the locomotor system were retrospectively evaluated. Of these, 43.7% claims were successful. The most frequent type of negligence was late diagnosis (34.2%), followed by inconsistent treatment (27.2%) and insufficient surgical revision (5.3%). In 33.3%, combined types of negligence were found. Most frequently, negligence was suspected after infection following hand surgery and internal fixation of long bones. The highest success rate of claims was seen after puncture of joints (69.2%). Insufficient documentation was confirmed in 15.3%. The majority of negligence resulted from diagnostic and therapeutic doubts, which could be avoided, e.g., by a clear definition of infection, consultation of a second opinion, a 2nd-look operation, undelayed and radical surgical revision, painstaking follow-up and disciplined documentation.

摘要

运动系统术后感染可能引发医疗事故诉讼。本研究的目的是确定这些索赔的成功率以及专家确认的医疗过失类型,以便提供避免此类过失的策略。对261例有关运动系统术后感染后疑似医疗事故的案例进行了回顾性评估。其中,43.7%的索赔成功。最常见的过失类型是诊断延迟(34.2%),其次是治疗不一致(27.2%)和手术翻修不足(5.3%)。在33.3%的案例中,发现了多种过失类型。最常发生在手部手术和长骨内固定术后感染后被怀疑存在过失。关节穿刺术后索赔成功率最高(69.2%)。15.3%的案例被证实存在记录不充分的情况。大多数过失是由诊断和治疗方面的疑问导致的,例如,可以通过明确感染的定义、寻求第二种意见、二次探查手术、及时且彻底的手术翻修、认真的随访和规范的记录来避免。

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