Malpractice Cases Research Articles

Testicular torsion is overrepresented among malpractice cases for gonadal torsion

Ovarian and testicular torsion are comparable surgical emergencies that may result in organ loss and, as such, have high litigious potential. We sought to describe the relative frequency and outcome of malpractice litigation between cases of ovarian and testicular torsion. Searches were completed in the Westlaw Jury Verdicts & Settlements and Lexis Cases databases using the following search terms: "(ovarian or ovary)/5 torsion" and "(testicular or testicle)/5 torsion". Cases were excluded if they were not directly related to torsion or were not malpractice claims. Cases were reviewed for year, jurisdiction, age of plaintiff, verdict, appeal status, contention, damages, and alleged time delay to appropriate care. The legal databases contained 155 malpractice cases related to testicular torsion and 4 cases related to ovarian torsion. Two of three ovarian torsion cases and 52% of testicular torsion cases with available rulings were in favor of the defense. The median age of plaintiffs in testicular torsion cases was 14, and 75% were minors. Median delay in care for testicular cases was 3 days, and median damages awarded to plaintiffs was $250,000 ($12,000-8.5 million). No data regarding age, delay in care, or damages were available for ovarian torsion cases. Among malpractice cases related to gonadal torsion, testicular torsion is vastly overrepresented despite literature demonstrating longer delays in care and greater likelihood of gonadal loss in ovarian torsion during the study period. IV.

How Data Can Drive Initiatives to Improve Patient Safety and Reduce Risk

Medical errors and improper care of patients are estimated to contribute to as many as 250,000 deaths each year. Critical insight into how, why, and where these incidents occur can be gained from close examination of medical professional liability data. Detailed taxonomy and coding of data can help guide organizational leaders and healthcare providers at all levels to identify key gaps in knowledge, skill, and protocols that may contribute to unfavorable outcomes. In this article, the authors explore how a large database of malpractice cases in the United States is assisting organizations in improving their patient safety programs.

Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis.

Medical malpractice complaints are apparently on the rise in Ghana. Though it has been suggested that medico-legal training programmes should emphasise the kinds of legal problems that healthcare staff encounter most frequently in practice, no comprehensive study currently analyses the pattern and outcomes of existing case laws. Systematic content analysis. Medical malpractice case laws sourced from Ghanaian legal repositories, media platforms and other grey literature sources. Nine case laws were retained. Most of the cases (n=7) involved negligence. Emerging patterns of cases are complex, including patients' access to their medical records, practising without a license/ out of scope, refusal to treat, and the development of complications following surgical interventions. Obstetrics & Gynaecology, Surgery, and Paediatrics were the main clinical specialties involved in the malpractice cases identified. The pattern of the cases suggests that all medical specialties are potentially at risk, although most of the cases emerged from Obstetrics & Gynaecology, Surgery, and Paediatrics. Medico-legal training for healthcare staff should emphasise the duty of care and adherence to the Ghana Health Service Patient Charter. None declared.

Penal Mediation as a Medical Dispute Settlement for Hospital Malpractice Cases in Indonesia

Penal Mediation is an alternative form of case settlement that originates with the idea of restorative justice. Seeing a large number of medical personnel being convicted in malpractice cases (primum remedium), mediation in dispute settlement for malpractice cases in hospitals becomes the concept of victim protection, harmonization, and overcoming rigidity/ formality in the applicable system. Therefore, the purpose of this study is to find solutions to avoid the adverse effects of the Criminal Justice System with the concept of mediation as an effort to resolve malpractice cases in the future. This paper used normative legal research or library research with a statute, conceptual, and comparative approach. The nature of the research used in this study is descriptive-prescriptive. The author used content analysis. The findings of this study are meant to provide an alternative solution to punishment which should be a last resort (ultimum remedium) from law enforcement in the form of non-litigation settlement through mediation.

Endodontic malpractice litigations in the United States from 2000 to 2021

Background/purposeLittle is known regarding the outcomes and distinguishing characteristics of lawsuits related to endodontic procedures. This study used a verdict-based data from United States of America to analyze the factors associated with endodontic malpractice lawsuits and mitigate the risk of litigation. Materials and methodsThe LexisNexis legal database was used to search for endodontic malpractice cases from January 1, 2000 to December 31, 2021 using the terms “medical malpractice” and (I) “endodontist” (II) “endodontics” (III) “root canal” (IV) “dental pulp.” Each case was reviewed for reported medical characteristics and litigation outcomes. ResultsA total of 650 cases were initially identified, and 97 cases were included in the final analysis. Eighty-four (86.6%) of the 97 defendants were general practitioners; 42 cases favored the plaintiff, 53 (54.6%) favored the defendant, 1 was partial win/loss, and 1 was settled. The annual case mean was 4.41 ± 2.17 (Mean ± SD). The major allegations favored for the patients involving paresthesia, root perforation, rubber dam not use, wrong tooth therapy, and infections. Plaintiffs who claimed with post-procedural reasons had a significantly higher winning rate than non-post-procedural reasons (P < 0.05). ConclusionIn the present study, 54.6% of endodontic litigation favored the dentists in the US. The authors recommend that general practitioners refer complicated cases to endodontists and treat carefully to avoid paresthesia, canal perforation and infections. Clinicians should always diagnose and treat correctly, shared decision making with the patient, use rubber dam routinely, and timely management to prevent malpractice claims.

The History of Medical Ethics in India

The History of Medical Ethics in India

Civil Liability of A Doctor In Malpractice Cases

The right to health is part of human rights guaranteed in the constitution. The state is obliged to strive for the fulfillment of these rights through the provision of health services. Concerning health services, the existence of doctors plays an important role. Juridically the medical profession has been regulated in “Law Number 29 of 2004 concerning the Medical Profession”. Based on the law, the relationship between doctor and patient is based on trust. In carrying out their duties, of course, doctors must hold fast to prioritizing the health of patients. However, there are malpractice actions that occur, causing harm to the patient. Juridically this is certainly a problem regarding the responsibility of doctors to patients. Therefore, in this paper, the author discusses how doctors are responsible for malpractice actions from the perspective of civil law. The method used in this paper is normative juridical with a statutory and conceptual approach.

Civil Liability of A Doctor In Malpractice Cases

The right to health is part of human rights guaranteed in the constitution. The state is obliged to strive for the fulfillment of these rights through the provision of health services. Concerning health services, the existence of doctors plays an important role. Juridically the medical profession has been regulated in “Law Number 29 of 2004 concerning the Medical Profession”. Based on the law, the relationship between doctor and patient is based on trust. In carrying out their duties, of course, doctors must hold fast to prioritizing the health of patients. However, there are malpractice actions that occur, causing harm to the patient. Juridically this is certainly a problem regarding the responsibility of doctors to patients. Therefore, in this paper, the author discusses how doctors are responsible for malpractice actions from the perspective of civil law. The method used in this paper is normative juridical with a statutory and conceptual approach.

Glaucoma-related malpractice litigation in the United States: A review of the WestLaw database

Purpose Gaining understanding of glaucoma-related malpractice litigation may highlight ways to improve patient care and minimize risk of litigation. This study aims to analyze the outcomes and characteristics of glaucoma-related malpractice litigation. Materials and Methods The Westlaw legal database (Thomson Reuters, New York, NY, USA) was used to identify cases regarding ‘malpractice’ AND ‘glaucoma’ or related terms. Cases were analyzed for characteristics such as alleged cause of malpractice, outcome, and demographics. Results The initial search terms yielded 498 results, 107 of which met further inclusion criteria. 38 (36%) were resolved via jury trial. Of these, verdicts in favor of the plaintiff were issued in 14 cases (34%), with median adjusted damages of $702,986. Of all 107 cases in the study reviewed, 65 (61%) resulted in verdicts in favor of the defendant. Ophthalmologists were named as defendants in 85% of the cases (with glaucoma specialists representing 7% of the ophthalmologists); optometrists in 24%. Sixty percent of the cases involved non-surgical treatment. The most common medical reasons for litigation were failure to diagnose (38%), and inappropriate/negligent treatment (36%). The most commonly litigated surgical procedures were cataract surgery (48%) and iridotomy/iridectomy (19%). Conclusion Glaucoma-malpractice litigation has increased, with medical mismanagement alleged in the majority of cases. Defendants are frequently successful in obtaining pre-trial dismissal, but the risk of liability increases in cases going to trial. A minority of cases involved glaucoma specialists. This historical analysis of glaucoma-related malpractice cases might provide perspective and aid physicians seeking to avoid litigation.

Lessons in liability: Examining medical malpractice suits against general surgeons in Maryland

BackgroundAlthough medical malpractice lawsuits pose a significant burden, there is a paucity of research on physician-specific characteristics influencing lawsuits against surgeons. Our objective was to identify factors associated with general surgeons being named in malpractice cases. MethodsThis was a cross sectional study of Maryland general surgeons, using malpractice data from a publicly accessible judiciary database. Case number per decade and lifetime lawsuit status were modeled with linear and logistic regression. ResultsMale surgeons had a higher average lawsuit volume (p = 0.002) and were more likely to be named in a malpractice case (p < 0.001). In regression analysis, a second graduate degree was a predictor of average cases per 10 years (p = 0.008) and male gender predicted lifetime lawsuit status (OR = 1.73, p = 0.046). ConclusionsMale gender was associated with increased odds of being named in a malpractice lawsuit. Identifying this difference is a preliminary step in developing interventions to reduce lawsuits amongst surgeons.

Problems of investigation of medical crimes in Ukraine

In the article, the authors identified the main reasons for the low level of investigation of medical crimes in Ukraine based on the analysis of 78 criminal cases of medical malpractice considered by courts since 2013, the study of statistical information, scientific literature on the problems of investigating medical crimes, national legislation. It was concluded there are significant problems with the investigation of medical crimes in Ukraine. Less than one percent of the number of initiated criminal cases is sent to court. Most of the cases sent to court end with a guilty verdict, however, medical workers are released from real deprivation or restriction of freedom for various reasons. According to the specialties of medical workers, the most criminogenic are obstetrics and gynecology, surgery, anesthesiology, and emergency care for injuries and internal diseases. Methods of committing medical crimes are associated with using incorrect methods of providing medical care and with the untimely or incorrect diagnosis of the disease. The problems of investigating medical crimes in Ukraine are due to a number of reasons, including the closeness of the results of the post-mortem examination of the corpse to relatives of the deceased, the lack of independent forensic medical examination institutions in Ukraine, and gaps in the legal regulation of the protection of medical records from unauthorized access. This greatly complicates the establishment of a causal relationship between the actions or inaction of medical workers and the negative consequences that have occurred.

The Application of Graph Theoretical Analysis to Complex Networks in Medical Malpractice in China: Qualitative Study.

Studies have shown that hospitals or physicians with multiple malpractice claims are more likely to be involved in new claims. This finding indicates that medical malpractice may be clustered by institutions. We aimed to identify the underlying mechanisms of medical malpractice that, in the long term, may contribute to developing interventions to reduce future claims and patient harm. This study extracted the semantic network in 6610 medical litigation records (unstructured data) obtained from a public judicial database in China. They represented the most serious cases of malpractice in the country. The medical malpractice network of China was presented as a knowledge graph based on the complex network theory; it uses the International Classification of Patient Safety from the World Health Organization as a reference. We found that the medical malpractice network of China was a scale-free network-the occurrence of medical malpractice in litigation cases was not random, but traceable. The results of the hub nodes revealed that orthopedics, obstetrics and gynecology, and the emergency department were the 3 most frequent specialties that incurred malpractice; inadequate informed consent work constituted the most errors. Nontechnical errors (eg, inadequate informed consent) showed a higher centrality than technical errors. Hospitals and medical boards could apply our approach to detect hub nodes that are likely to benefit from interventions; doing so could effectively control medical risks.

A New Teaching Tool for Peer Review of Charting and Care in the Emergency Department

Poor documentation, incomplete medical decision-making, missing progress notes, and inappropriate care play a major role in medical malpractice cases. We introduced a new quality improvement (QI) process focused on evaluating and improving documentation and clinical care. We hypothesized that a modified, simplified QI scoring rubric would demonstrate inter-rater reliability among attending physicians and provide a useful new standardized tool for both QI departmental review and peer review. We modified a previously developed rubric template that demonstrated high inter-rater reliability for a more streamlined, simpler, and more generalized application. We developed a new system using three discrete templated sections with choices limited to five options. Eight experienced attending physicians evaluated the same 10 charts using our scoring rubrics. Consistency among raters was assessed using the Shrout-Fleiss relative: fixed set mean kappa scores.Our statistical analysis found excellent consistency among our experienced raters for both the documentation (κ = 0.91) and clinical care (κ = 0.84) scoring tools. We conclude that a modified, simplified QI scoring rubric demonstrates inter-rater reliability among experienced attending physicians. We believe this tool can be used as a standardized tool for a departmental review process by experienced quality leaders as well as by faculty to provide peer review while improving their own charting prowess. We further used this tool for peer review by having the attending staff participate in reviewing a specified number of charts using our modified template with explicit criteria so they could provide feedback as well, while gaining a better understanding of the elements of a "good" chart and of opportunities for improved care and resource utilization. By using this tool, we were able to provide more than 50 attendings summative feedback on their charting by a group of their peers that was both numerical and descriptive.

Investigation of the lawsuits regarding Down syndrome

Objective: To examine the number of cases filed about Down syndrome in terms of its numbers, causes and consequences, to provide an overview of what doctors should pay attention to when informing and consulting patients and during follow-up and recommend solutions for decreasing the number of malpractice cases. (Discussing the legal aspect of the decisions is beyond the scope of this research.) Materials and Methods: ‘Down’, ‘Down sendromu’ ‘Down’s, ‘trizomi 21 ‘, ‘trisomi 21’ and ‘trisomy 21’ was written to ‘ https:// karararama.yargitay.gov.tr/ ‘ and ‘https://karararama.danistay.gov.tr/’ web addresses search engines and the data was examined with Microsoft Excel or with R version 4.0.5 ( 2021-03-31) for bias and frequency table was used and the results were examined. Results: A total of 53 cases were found. 49 supreme court and 4 Council of State court decisions are found. The cases are from 27.10.2009 to 13.10.2021. Conclusion: A total of 39 different Down syndrome cases were examined, as 6 of the 53 cases were related to the same cases and 8 of them were cases not related to Down syndrome. 28 cases are “doctor negligence”, 5 are “reckless killing”, 1 “material mixing in the genetic center”, 1 “unauthorized use of the child’s photo”, 1 “stealing money from the child”, 1 “intentionally injuring the child”, 1 ‘inheritance request for the child’ and 1 on ‘guardianship’.

Investigation of the lawsuits regarding down syndrome

Objective: To examine the number of cases filed about Down syndrome in terms of its numbers, causes and consequences, to provide&#x0D; an overview of what doctors should pay attention to when informing and consulting patients and during follow-up and recommend&#x0D; solutions for decreasing the number of malpractice cases. (Discussing the legal aspect of the decisions is beyond the scope of this&#x0D; research.)&#x0D; Materials and Methods: ‘Down’, ‘Down sendromu’ ‘Down’s, ‘trizomi 21 ‘, ‘trisomi 21’ and ‘trisomy 21’ was written to ‘ https://&#x0D; karararama.yargitay.gov.tr/ ‘ and ‘https://karararama.danistay.gov.tr/’ web addresses search engines and the data was examined with&#x0D; Microsoft Excel or with R version 4.0.5 ( 2021-03-31) for bias and frequency table was used and the results were examined.&#x0D; Results: A total of 53 cases were found. 49 supreme court and 4 Council of State court decisions are found. The cases are from&#x0D; 27.10.2009 to 13.10.2021..&#x0D; Conclusion: A total of 39 different Down syndrome cases were examined, as 6 of the 53 cases were related to the same cases and 8&#x0D; of them were cases not related to Down syndrome. 28 cases are “doctor negligence”, 5 are “reckless killing”, 1 “material mixing in the&#x0D; genetic center”, 1 “unauthorized use of the child’s photo”, 1 “stealing money from the child”, 1 “intentionally injuring the child”, 1&#x0D; ‘inheritance request for the child’ and 1 on ‘guardianship’.

E-Cheating Awareness and Attitudes of Senior Secondary Certificate Examinations’ (Ssce) Candidates in Ondo State, Nigeria

The study examined the E-cheating awareness and attitudes of senior secondary certificate examination’s (SSCE) candidates in Ondo state with the view of proffering solution to reported cases of examination malpractices in the study locate. The sample for the study comprised three hundred and ten (310) candidates selected from five coaching centres through purposive sampling techniques. Two research questions guided the study using two instruments named: Students’ E-cheating Awareness Questionnaire (SEAQ) and Students’ Attitude to E-cheating Scale (SAES). The instruments were given experts’ validation. The results were analyzed using frequency count and mean statistics. The result showed (mean=2.54) indicating that the SSCE candidates were aware that questions and answers were online prior to the day of their examinations and some students have access to SSCE questions and their answers through various websites. Further, the result indicated that larger proportion of the candidates (mean=3.52) had positive attitude to E-cheating with the opinion that cheating in examination was good and helped students to pass. The study found that the respondents were of the notion that since Nigerian leaders were corrupt, nothing is wrong in electronic cheating. It was therefore recommended that integrity clubs should be established in schools to develop in students’ examination ethics and help them to acquire the values of handwork that will checkmate their involvement in examination malpractices.

Mock trials and web-based education using malpractice cases: A randomised controlled trial

<h2>ABSTRACT</h2><h3>Background</h3> Web-based education using malpractice cases is increasingly used as an effective program to improve nurses' patient safety competency, and education on legal obligations is vital for nursing students. <h3>Aim</h3> To evaluate the effectiveness of web-based education using mock trials of medical malpractice cases in improving nursing students' legal obligations, patient safety competency, and critical thinking. <h3>Methods</h3> Forty-three senior nursing students were randomly assigned to be exposed to blended learning of mock trials (4 weeks) and web-based education (4 weeks) in experimental group (n = 23), and web-based education (4 weeks) alone in control group (n = 20). Pre-test (before randomisation) and post-test (after intervention) data were collected at a university in Korea between October and December 2019. <h3>Results</h3> There were statistically significant differences in patient safety competencies (t = 3.59, <i>P</i> = 0.001), including skills (t = 2.89, <i>P</i> = 0.006) and knowledge (t = 2.60, <i>P</i> = 0.013), as well as a significant difference in critical thinking disposition (t = 3.09, <i>P</i> = 0.004) between the two groups in the pre−post changes. The two groups had no difference in knowledge and cognition of legal obligation. <h3>Conclusion</h3> Blended learning of mock trials and web-based education can enhance nursing students' patient safety competency. In particular, mock trials are an active participatory learning method that helps nursing students develop critical thinking skills to ensure patient safety competency compared to web-based education alone. Incorporating mock trial education using medical malpractice cases into the curriculum could enhance nursing students' patient safety competency and critical thinking disposition.

Characterizing and learning from medical malpractice cases against medical oncologists using a national claims database.

318 Background: Malpractice cases may contain valuable information to inform safety improvement efforts in cancer care. No analyses of malpractice cases have been published focusing on medical oncologists as the primary defendant. The recent development of a new safety incident taxonomy for medical oncology enabled us to classify malpractice cases and identify patient safety improvements.1. Methods: We conducted a qualitative analysis of case vignettes naming medical oncologists as the primary defendant. Case vignettes were obtained from CRICO’s Candello database. Of 452 cases against medical oncologists, a random sample of 100 cases was selected. Cases were coded for the type of safety incident, and whether a system solution could plausibly reduce the risk of a future event. Coding was performed by 3 physicians with experience caring for patients with cancer. Two reviewers reviewed each case; discrepancies were resolved by the third reviewer. Results: Ninety-nine cases were included in the final analysis; 1 was determined to be misassigned to medical oncology as the primary defendant when the case vignette was entirely about radiation oncology treatment and side effects. The most frequent cancer types were breast (16%), acute leukemia (9%), aggressive lymphoma (8%), and gynecologic malignancies (7%). The most common safety incidents identified were provider clinical management errors (41%), adverse drug reactions (20%), relational issues among providers, patients, and other healthcare staff (13%), and prescriber ordering errors (6%). 47 case vignettes described safety incidents that might have been prevented by a systems intervention. The most common interventions were “tumor board or expert review of rare or uncertain cases” (19%), “pharmacist review for safe prescribing of chemotherapy” (17%), “cancer navigator for appointment scheduling in high-risk settings” (9%), “closed loop communication with radiology” (6%), and “electronic patient portal access to all test results” (6%). Conclusions: Using a new medical oncology-focused incident coding taxonomy, we were able to classify all 99 malpractice cases. Human factors issues accounted for the majority of claims. We determined that more comprehensive use of existing improvement interventions might substantially reduce the risk of future events. 1 Jacobson, J. et al. Development of a taxonomy for characterizing medical oncology-related patient safety and quality incidents: A novel approach. BMJ Open Quality. [Manuscript in press]. Accepted June 10, 2022. DOI 10.1136/bmjoq-2022-001828.R2.

Malpractice against shoulder surgeons: what the data say.

Thousands of orthopedic surgeons in the United State face medical malpractice claims annually; however, little is known regarding the common causes for litigation against shoulder surgeons. In addition, the current analysis does not take into consideration how surgical frequency affects the litigation likelihood. The purpose of our investigation was to identify the most common causes of litigation against shoulder surgeons in the United States adjusting for surgical frequency. The VerdictSearch database was used using the search terms "medical malpractice," "shoulder," and "NOT cancer." Results were queried, and all studies pertaining to orthopedic shoulder surgery included. Data gathered included cause of lawsuit, indemnity paid, type of surgery performed, results of the cases, verdict or settlement, and, if applicable, technical error. A query of a multisurgeon institutional database was conducted to determine how frequently surgeries were performed. Then the frequency of litigation was adjusted by the procedure frequency to determine which surgery has the greatest likelihood to be litigated relative to rotator cuff surgery. Forty-five cases were included in our study. After adjusting for the procedure frequency, the most likely procedure to be litigated, relative to rotator cuff repair, was manipulation under anesthesia (MUA), 251 times more likely to be litigated, and washout/lavage procedures, 17 times more likely to be litigated. Injection and total shoulder arthroplasty were 23 and 14 times less likely to be litigated relative to rotator cuff repair, respectively. In addition, the average age of the patients was 47 years, and 53% of the cases involved a male plaintiff. The most commonly litigated procedures were rotator cuff repair (42%), MUA (13%), and humeral open reduction and internal fixation (9%). The most commonly cited symptoms for litigation against shoulder surgeons were pain (60%) and loss of range of motion (40%). Of the 45 cases, 44% ended in physician loss, with the average indemnity paid via verdict being $1,118,714 vs. $416,875 for settlement. This study identifies that MUA and lavage/washout procedures are much more likely to be litigated relative to rotator cuff repair. Rotator cuff repair is actually one of the least likely procedures to be litigated. Furthermore, settlement may represent a method of decreasing the indemnity paid for malpractice cases for which surgeons are implicated.

Medical Malpractice Trends in Dacryocystorhinostomy and Orbital Decompression.

This study aims to evaluate the medicolegal trends related to 2 common orbital surgeries: orbital decompression and dacryocystorhinostomy (DCR). These procedures are performed by ophthalmologists, otolaryngologists, and multidisciplinary teams of both specialists. The Westlaw database was reviewed from 1980 to 2020 for medical malpractice cases involving orbital decompression and DCR surgeries. Data were compiled on plaintiff and defendant demographics, procedure performed, legal allegation, nature of injury, and verdict or settlement awards. The Ophthalmic Mutual Insurance Company was also queried for all malpractice cases pertaining to orbital decompression and DCR from 1995 to 2021. The Westlaw database included 60 cases (34 orbital decompression, 26 DCR); of these, 8 orbital decompression and 6 DCR cases met inclusion criteria. Of the 7 orbital decompression cases that were tried, a verdict in favor of the plaintiff occurred in 4 cases (57%). Of the 5 DCR cases that were tried, a verdict in favor of the plaintiff occurred in 2 cases (40%). A search of all claims at OMIC yielded 31 cases (15 orbital decompression, 16 DCR). 22 of 31 cases were either dismissed or resulted in no payment. The remainder was settled out of court, with only one case being tried and the verdict supporting the defendant. Despite several thousand orbital decompressions and DCR surgeries being performed annually in the US, very few lawsuits involving these complex surgeries have gone to trial. However, of the cases that did go to trial, a relatively high proportion of verdicts for plaintiffs was observed.