13 - Medicolegal Issues in ERCP

Abstract

ERCP is a complex and difficult procedure with significant risks for adverse patient outcomes and for medical litigation. It is important for endoscopists performing ERCP to understand liability issues related to ERCP, including vicarious liability, and to understand the legal principles important in medical practice, including the elements of a malpractice case, standards of care, and informed consent. The endoscopist must realize that the deviations from a reasonable standard of care most likely to lead to ERCP-related medical litigation include procedural indications, procedural technique, post-ERCP care, and issues of informed consent. With this understanding, the endoscopist performing ERCP can formulate and adopt risk management strategies to improve patient safety, satisfaction, and outcomes while minimizing the risk of litigation. These strategies include practicing within a reasonable standard of care, focusing attention on the informed consent process and documentation, and understanding specific patient-related and technique-related risk factors for complications and lawsuits. The most important single protection is to show the patient and family that you care about them, before and after the procedures, whatever the outcome might be.