Malpractice Risk Research Articles

Examining Nursing Medical Malpractice Cases Related to Medications.

The aim of this study was to analyze medication-related nursing medical malpractice cases to gain insights regarding how malpractice risk can be reduced. The criminal prosecution and verdict of nurse RaDonda Vaught focused attention on the potential medicolegal risk for nurses related to medications. Medication-related medical malpractice cases involving nurses were obtained from a national database. Various attributes of these cases were examined, including contributing factors, injury severity, and case outcomes. Authors identified 231 nursing medication-related medical malpractice cases closed from 2017 to 2021. The most frequent adverse events involved medication administration. Not following policies or protocols was the most common contributing factor. Opioids and epinephrine were the medications most frequently involved in the cases. Indemnity payments were made in 56.3% of the cases, with an average indemnity payment of $366 002. Nursing medication-related medical malpractice cases are relatively uncommon, which may reassure nurses regarding medicolegal risk. Medications and contributing factors involved in the cases suggest patient safety interventions including education related to policies, procedures, and protocols.

Risk Retention and Management Implications of Medical Malpractice in the Italian Health Service

This work provides an economic exploration of the multifaceted world of medical malpractice risk. Third party liability insurance plays a central role in protecting healthcare providers and public care institutions from the financial consequences of medical malpractice claims, although in recent years, the industry landscape has been characterised by periods of distress for this type of protection, with rising litigations and reimbursement costs, resulting in a peculiarly complex market. For the Italian context, the study focuses on the financial repercussions for healthcare institutions of the growing trend towards risk retention practises, legally empowered by the introduction of Law No. 24/2017. The analysis employs Generalised Linear Models for the regressive approach to incorporate the structural and organisational characteristics of hospitals and uses quantitative simulations to explore different scenarios at a regional aggregate level. Due to the limited existing literature and data on the topic, this research aims to provide new methods for effectively understanding and managing this type of risk, thereby supporting decision-making processes in the healthcare sector.

Malpractice rates are lower for women physicians compared to men physicians

Background Previous literature has shown that women physicians are less likely to be involved in medical malpractice litigation than male physicians. Methods This study sought to examine the differences in malpractice experience by provider gender by using closed medical malpractice claims from 2011 through 2020. Results We found that after adjusting for the number of claims and dollar losses per full time equivalents worked, female physicians experienced fewer and less costly claims than male physicians ( p < .001). Specific specialties had a significant relationship between claim frequency and provider gender, which included general surgery ( p = .01), obstetrics ( p = .001), gynecology ( p = .04), internal medicine and family general practice ( p < .001). Conclusion The results from this analysis support the prior findings that male physicians experience a higher rate of malpractice claims. Therefore, there is an opportunity to learn how women providers achieve lower malpractice risk to inform clinical practice recommendations.

A retrospective study of pet owners' complaints against veterinary practices in Türkiye (2012-2021).

The objective of this study was to examine in detail the complaints against veterinarians submitted by pet owners and evaluated by the Turkish Veterinary Medical Association in Türkiye, with the aim to create awareness among Turkish veterinarians about the nature of the complaints and how they might reduce the risk of making medical errors. 127 files of complaints. A total of 127 written complaints from pet owners filed between January 2012 and December 2021 were analyzed. The pet owners' complaints were subjected to a conventional content analysis to identify the primary, secondary, and tertiary themes. Each case was evaluated by a 3-level complaint-coding taxonomy. The first level included 3 domains (themes), namely clinical, management, and relationship, while the second level was ordered in a total of 7 subcategories of complaint types. Thereafter, the third-level minor themes were grouped into related subcategories. From 127 file complaints, 296 specific issues were identified. Of these, 62% were in the clinical domain, 24% in the management domain, and 14% about poor behavior of the attending veterinarians. The most common (43%) complaint was medical errors. An increased awareness of common medical errors should be promoted among Turkish veterinarians in order to reduce the risk of negligence and malpractice.

Risk of malpractice in ultrasonography and POCUS

Background and aim. The Hippocratic oath that all physicians take when admitted to the Romanian College of Physicians starts from their obligation not to harm patients: primum non nocere. Non-maleficence is also one of the primary perceptions of bioethics that medical students learn from the first years of their studies. This review presents the current state of POCUs in Romania's neonatology and the physicians' challenges regarding the risk of malpractice in this field. Material and methods. The issues of malpractice focused on ultrasound, the challenges of the POCUs, and the process of training and obtaining informed consent for this procedure are analyzed. Also, the risks for liability related to this issue and the appropriate conduct in this field are presented. Results. Every physician must assume the consequences of his or her decisions, and when they are evaluated for the charge of malpractice, this evaluation is made by reference to the legal rules in force. POCUS is a branch of ultrasonography increasingly used in multiple medical specialties. Informed consent must be obtained before the ultrasound examination. No ultrasound examination of the newborn or POCUS assessment will be performed without prior informed consent of the legal guardian, who will also sign the consent. Although the benefits of POCUS are undeniable, this procedure can come with several risks for patients. Unfamiliarity with the legal aspects of performing this complex medical act can easily push the physician into the area of medical malpractice. Proper training in the field of ultrasonography, respect for the limits of competence, and compliance with all the requirements of the law regarding the medical act guarantee the safe performance of medical procedures, both for the patient and the physician. Conclusion. Based on the data mentioned above, in order to perform reliable POCUS examinations, it is recommended that a complementary ultrasonography curriculum from the existing national ultrasonography curricula be completed.

Telemedicine: International Law Comparison

The main problems in telemedicine include the lack of uniformity in international regulations, limited technological infrastructure in some countries, and data protection and patient privacy. Additionally, legal responsibilities and malpractice risks have not been standardized. Gaps in access to services, especially in remote areas, and ethical challenges and quality standards are also obstacles. The purpose of this research is to find out international legal considerations regarding the use of Telemedicine and find solutions to overcome Telemedicine legal issues. This research uses a normative juridical approach with an emphasis on comparative studies. The results of the research were then analyzed qualitatively. Based on research results, show that Telemedicine is regulated differently in various countries. In Indonesia, it is regulated by Minister of Health Regulation Number 20 of 2019 for diagnosis, treatment, and continuing education with service costs borne by the health facility. Malaysia has a Telemedicine Act 1997, focused on follow-up care and drug prescriptions, growing rapidly in the private sector during the COVID-19 pandemic. Argentina published telehealth guidelines in 2019 and 2022, requiring health insurance companies to adopt teleconsultation platforms. Austria through the TeleHealth Commission since 2013 regulates telemonitoring, teletherapy, teleconciliation, and teleconferencing with strict data protection laws. Mexico integrates telehealth in general health services, regulated by IMSS and ISSSTE, while Russia regulates through the Health Protection Law with strict IT requirements. International telemedicine legal solutions require harmonization of regulations, personal data protection, information security standards, recognition of professional licenses, dispute resolution mechanisms, and legal liability regulations. Education and public awareness are essential to overcome these challenges, supported by international cooperation that strengthens the global legal infrastructure of telemedicine.

Beyond the Signature: Informed Consent from a Legal Perspective and Its Implications for Plastic Surgery.

Informed consent is the principal tool that bridges the gap between clinical practice and our society's ethical ideals. The intricacies of informed consent, however, are frequently misunderstood, and its effective implementation can be challenging in practice. The continuous stream of innovations, wide array of procedures, and other characteristics inherent to the practice of plastic surgery compound the challenges of implementing informed consent. Unfortunately, there remains a dearth of literature to provide a comprehensive overview of informed consent as it relates to plastic surgery. In this article, the authors highlight the history, legal components, and challenges of informed consent within plastic surgery and offer recommendations on how to approach them. A deeper understanding of informed consent helps enhance patient care, mitigates unnecessary malpractice risk, and leads to better physician-patient relationships.

Attitudes and barriers toward video visits in surgical care: Insights from a nationwide survey among surgeons

BackgroundSurgeons rapidly adopted video visits during the COVID-19 pandemic. However, video visit use among surgeons has significantly declined, pointing to the need to better understand current attitudes and barriers to their use in surgical care. MethodsFrom August 2022 to March 2023, a nationwide survey was conducted among practicing surgeons in 6 specialties. The survey included multiple-choice and free-response questions based on an implementation determinants framework, covering demographics, provider, patient, and organizational factors. ResultsA total of 170 surgeons responded (24% response rate). Overall, 67% of surgeons said their practice lacked motivation for video visit implementation. Additionally, 69% disagreed with using video visits as the sole means for preoperative surgical consultation, even with relevant medical history, labs, and imaging. Nearly 43% cited the need for a physical examination, whereas 58% of surgeons said video visits carried a greater malpractice risk than in-person visits. Other barriers included technological limitations, billing, and care quality concerns. Nevertheless, 41% agreed that video visits could improve outcomes for some patients, and 60% expressed openness to using video visits exclusively for postoperative consultations in uncomplicated surgeries. ConclusionSurgeons recognize the potential benefits of video visits for certain patients. However, perceived barriers include the need for a physical examination, technological limitations, care quality concerns, and malpractice risks.

PERLINDUNGAN TERHADAP PERKEMBANGAN LAYANAN KESEHATAN BERBASIS KECERDASAN BUATAN (ARTIFICIAL INTELLIGENCE) DI INDONESIA

Artificial Intelligence-based (AI) Health Service is a solution to the limited number and distribution of doctors in Indonesia. However, the use of AI technology also presents several challenges. This research used a normative juridical approach to analyse protection regarding the development of AI-based technology-based health services in Indonesia. The analysis shows that challenges to utilizing AI in healthcare include bias, protection of personal data and risk of malpractice. As a system that has no moral values, doctors is expected to be wiser in operating it. To ensure the delivery of quality AI-based health services, patients, doctors, service providers and the government need to understand and carry out their respective roles collaboratively.

Artificial intelligence in clinical nutrition and dietetics: A brief overview of current evidence.

The rapid surge in artificial intelligence (AI) has dominated technological innovation in today's society. As experts begin to understand the potential, a spectrum of opportunities could yield a remarkable revolution. The upsurge in healthcare could transform clinical interventions and outcomes, but it risks dehumanization and increased unethical practices. The field of clinical nutrition and dietetics is no exception. This article finds a multitude of developments underway, which include the use of AI for malnutrition screening; predicting clinical outcomes, such as disease onset, and clinical risks, such as drug interactions; aiding interventions, such as estimating nutrient intake; applying precision nutrition, such as measuring postprandial glycemic response; and supporting workflow through chatbots trained on natural language models. Although the opportunity and scalability of AI is incalculably attractive, especially in the face of poor healthcare resources, the threat cannot be ignored. The risk of malpractice and lack of accountability are some of the main concerns. As such, the healthcare professional's responsibility remains paramount. The data used to train AI models could be biased, which could risk the quality of care to vulnerable or minority patient groups. Standardized AI-development protocols, benchmarked to care recommendations, with rigorous large-scale validation are required to maximize application among different settings. AI could overturn the healthcare landscape, and this article skims the surface of its potential in clinical nutrition and dietetics.

Factors affecting the choice of medical specialties in Turkiye: an analysis based on cross-sectional survey of medical graduates

BackgroundModern healthcare systems require the right mix of medical specialties for effective provision of high-quality services. Despite increased availability of general physicians and specialists, Türkiye lags behind high-income countries in terms of availability of specialists. The purpose of the study is to identify several specific factors that affect the choice of medical specialization.MethodsAll 350 medical school graduates in a specialty examination preparation bootcamp were requested to participate in the survey and 333 completed the self-administered questionnaire. The survey asked questions about factors affecting choice of medical specialty by medical graduates.ResultsThe empirical results indicate that surgical specialties, compared to other broad medical specializations, are selected because of its higher income-earning potential and social prestige. The likelihood of selecting surgical specialties is negatively affected by rigorousness of the training program, high work-load, risk of malpractice lawsuits and risk of workplace violence. Male participants were 2.8 times more likely to select surgery specialty compared to basic medical science. Basic medical science areas were selected at a higher rate by female graduates and graduates with high level of academic performance in medical schools.ConclusionsIt is critically important to improve trust and inter-personal communications between the patients and physicians in all specialties to lower the likelihood of malpractice lawsuits and workplace violence. Policy-makers may adopt policies to affect income earning potential and social prestige of targeted specializations to improve their supply.

A Decade of Lawsuits Against Surgeons Performing Female Genital Cosmetic Surgery (FGCS) in Tehran, Iran.

The objective of this study is to evaluate the legal proceedings that arise from Female Genital Cosmetic Surgeries (FGCS) and analyze the reasons why women file complaints against their surgeons. Additionally, we examined the outcomes of the legal decisions associated with these complaints. This descriptive cross-sectional study was conducted in Tehran province, Iran, from 2012 to 2021. The primary data source for this study was forensic medical records, which were reviewed to gather relevant information. The collected data included the characteristics of the participants, the reasons for lawsuits, the procedure setting, and the outcomes of the legal decisions. A total of 121 patients were examined in the study, revealing that Labiaplasty was the most prevalent procedure (49.6%), followed by vaginoplasty (19.8%) and perineoplasty (13.2%). The most common complaints were related to cosmetic concerns (57%), lack of recovery (26.4%), and sexual dysfunctions (22.3%). Healthcare providers were found liable for malpractice in 52.1% of cases. Additionally, having the surgery performed by a gynecologist decreased the risk of malpractice (β = 0.21, p= 0.034), while procedures in private clinics increased the risk (β = 2.95, p = 0.040). The study's findings emphasized the importance of providing women with comprehensive education and consultations to ensure they are well-informed about the potential outcomes and risks of FGCS. Furthermore, the study highlighted the significance of having these surgical procedures performed by skilled and experienced surgeons. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Factors Influencing the Application of the Code of Nursing Ethics at Indonesia

Background: Nurses are health workers who are vulnerable to lawsuits because the scope of services performed carries a risk of malpractice and negligence. Aim: This study was aimed to determine the application of a code of ethics in health services and analyze the influencing factors, as well as analyze the factors with the strongest influence. Methods: The study used an explanatory research method with a cross sectional approach. The population in this study were nurses who worked in health services, both in hospitals and health centers in the Surabaya area. The sample size in this study was calculated using the rule of thumb, amounting to 150 respondents. Samples were taken by means of purposive sampling, data were analyzed by path analysis with a significance level of α <0.005. Result: Nurses apply a code of ethics in the good and excellent categories. The influencing factors were individual characteristics (p=0.000), work environment characteristics (p=0.000), experience (p=0.000), knowledge (p=0.000). The biggest influencing factor is experience with a large influence on knowledge is 0.803 and the influence on the application of the code of ethics is 0.823. Conclusion: Most nurses in Indonesia have implemented a code of ethics in the good and excellent categories. Factors that influence the application of the code of ethics in health services are individual characteristics, characteristics of the work environment, experience. and knowledge. The most influential factor is experience. Nurses should be active in the activities of professional organizations. Workplace rotation is needed for nurses to gain experience in decision making, legal ethics

Improving Nurse-Physician Bedside Communication Using a Patient Experience Quality Improvement Pilot Project at an Academic Medical Center.

Introduction Patient experience is a crucial aspect of healthcare delivery, and it encompasses various elements that contribute to a patient's perception of the care they receive. Patient satisfaction and patient experience are related but distinct concepts. Patient experience focuses on whether specific aspects of care occurred, while patient satisfaction gauges whether patient expectations were met. It goes beyond mere satisfaction and delves into the broader aspects of how patients interact with the healthcare system and the quality of those interactions, with health plans, doctors, nurses, and staff in various healthcare facilities. Other aspects highly valued by patients include elements such as timely access to care and information, good communication with the healthcare team, and friendly staff. Patient experience can influence both the healthcare and financial outcomes of healthcare facilities. It is well understood that positive patient experiences may lead to better care adherence, improved clinical outcomes, enhanced patient safety, and better care coordination. Payers, both public and private, have recognized the importance of patient experience. Improving patient experience benefits healthcare facilities financially by strengthening customer loyalty, building a positive reputation, increasing referrals, and reducing medical malpractice risk and staff turnover. Methodology A multidisciplinary retrospective quality improvement initiative was initiated to effectively improve nurse-physician communication and organizational outcomes in several hospital units. Results Using an innovative staff-developed and driven acronym, IMOMW (I'm on my way), the study demonstrated significant positive outcomes such as increased Epic documentation (Epic Systems Corporation, Verona, Wisconsin, United States) of physician and nursing rounding by 13%, a 10.5% rise in recommend facility net promoter score (NPS) patient experience survey scores, 13.4% increase in physician and nurse team communication, 5.4% increase in nursing communication, and a 5.3% increase in physician communication. Moreover, pilot units outperformed the control group consisting of medical-surgical units located in newer portions of the hospital. Conclusion This quality improvement study demonstrates improved interdisciplinary nurse-physician communication, Epic documentation, and patient experience scores. Further investigation is necessary to better understand the specific factors and/or processes that influence the sustainability of interventions that improve nurse-physician communication and patient experience.

Never events in plastic surgery: An analysis of surgical burns and medical malpractice litigation

IntroductionBurns and fires in the operating room are a known risk and their prevention has contributed to many additional safety measures. Despite these safeguards, burn injuries contribute significantly to the medical malpractice landscape. The aim of the present study is to analyze malpractice litigation related to burn and fire injuries in plastic and reconstructive surgery, identify mechanisms of injury, and develop strategies for prevention. MethodsThe Westlaw and LexisNexis databases were queried for jury verdicts and settlements in malpractice lawsuits related to burn and fire injuries that occurred during plastic surgery procedures. The Boolean terms included “burn & injury & plastic”, “fire & injury & “plastic surg!”” in Westlaw, and “burn & injury & “plastic surg!””, “fire & injury & “plastic surg!”” in LexisNexis. ResultsA total of 46 cases met the inclusion criteria for this study. Overheated surgical instruments and cautery devices were the most common mechanisms for litigation. Plastic surgeons were defendants in 40 (87%) cases. Of the included cases, 43% were ruled in favor of the defendant, while 33% were ruled in favor of the plaintiff. Mishandling of cautery devices 6 (13%), heated surgical instruments 6 (13%), and topical acids 2 (4%) were the most common types of errors encountered. ConclusionNever events causing burn injury in plastic and reconstructive surgery are ultimately caused by human error or neglect. The misuse of overheated surgical instruments and cauterizing devices should be the focus for improving patient safety and reducing the risk of medical malpractice. Forcing functions and additional safeguards should be considered to minimize the risk of costly litigation and unnecessary severe harm to patients.

Telemedicine practice among Egyptian urologists: knowledge, attitude, and medicolegal concerns

BackgroundThe usage and implementation of telemedicine by urologists to diagnose, treat, mentor, and prevent diseases have grown worldwide. Numerous clinical, legal, and ethical issues are addressed by this practice. This is a cross-sectional study based on an anonymous online questionnaire, aimed to assess the current urologists’ knowledge and attitude towards telemedicine use in Egypt. A total of 108 Egyptian urologists filled out the questionnaire which included sociodemographic data, urologist knowledge, attitude regarding telemedicine, and common concerns and barriers.ResultsOut of the total sample, 75.9% of participants did not use telemedicine modalities until COVID-19 pandemic. Nearly 66.7% of participants did not receive formal medicolegal training on using telemedicine. About 62% of participants used personal accounts on social media, and 73.1% of teleconsultations were to assess radiological and laboratory data. Several concerns were highlighted such as possible malpractice risks (79.6%), defamation (72.2%), and keeping patient records (71.3%). Urologists raised many considerable barriers regarding telemedicine, such as lack of patient technology skills (84.3%), absence of regulations or laws (76.9%), insurance reimbursement (57.4%), and lack of administrative support (53.7%). Most of the participants have a positive impression of the advantages of tele-urology. There was a statistically significant difference between the number of cases seen per week and positive total attitude score.ConclusionsAlthough most participants practiced telemedicine, many obstacles were highlighted through the study. Ignoring legal, ethical, personal, and patient issues may also jeopardize the future of telemedicine. Well-established health policies, formal education, and the implementation of regulated laws of telemedicine are fundamental.

POLEMIK MALPRAKTIK DAN RISIKO MEDIK

The term negligence is part of professional incompetence, from a health perspective, the term negligence is called malpractice, meaning bad practice, giving rise to claims that go to court. Whereas, medical risks are unexpected events, such as surgery or other medical procedures, which contain medical risks which can actually become an obstacle to medical practice. Society finds it difficult to differentiate between malpractice and medical risk, so it is important to share this knowledge with legal officials and society, so that it does not become a polemic throughout the ages.

Medical malpractice stress syndrome in theory and practice - a narrative review

Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as "second victims" of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988-2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513-26.

Evaluating Medical Students' Knowledge of Medical Malpractice: A Pilot Study

Introduction: Although medical malpractice lawsuits are common and have a tremendous financial and psychological impact on physicians, education about medical malpractice is almost non-existent in most medical school curricula around the world. Nonetheless, medical students are concerned about looming legal lawsuits during their careers and have expressed desire to become educated. The objective of the present study is to evaluate and gauge baseline medico-legal knowledge of medical students. Methods: A survey with 25 multiple-choice quiz questions regarding malpractice risks, standards of care, and malpractice premiums was prepared with information obtained from peer-reviewed articles after a thorough literature review failed to produce a validated questionnaire for medical students. The survey was distributed to medical students across 5 consecutive years at our medical school, totaling 420 students. Data from the survey was collected via Qualtrics before undergoing statistical analysis. Results: The completion rate for the survey was 110/420 (26.2%). The results showed that no group of students scored greater than 50% correct on the survey, with an overall median score of 40% correct for all students combined. Fourth year medical students correctly answered 1.77 more questions, on average, than first year medical students. There were no statistically significant differences in survey score between students with a personal or familial medical malpractice involvement. Discussion: The results are an indication that students are not well-educated about medical malpractice, and that medical malpractice education should be implemented in medical school to help prepare future physicians to protect their patients and hopefully avoid malpractice lawsuits.

Risk Analysis of Malpractice at Central General Hospital Friendship Jakarta

In the world of health services, many risks may be used as legal cases, ranging from the arrival of patients' data collection until patients leave the place of service. Europe and America have characteristics of different types of malpractice incidents, and in Asia, there are both developed, developing, and underdeveloped countries. This study aims to examine and analyze the prevention of malpractice risk and the mechanism of malpractice risk at Friendship Center General Hospital. The research methods used are empirical and conceptual juridical research methods. Researchers use literature studies as a tool for collecting research materials. The results of the study found that Permenkes 11 of 2017 states that Patient Safety aims to improve the Quality of Service in health Service Facilities through the application of Risk Management in all Aspects of Health Services, which means that it is expected that with the application of good Risk management, the risk for complaints that lead to malpractice reporting in any form can be suppressed in such a way. Although the application of standard operating procedures in hospitals, the risk of malpractice complaints is still possible due to many things from various angles that cannot be explained in the regulations or cannot be explained due to other things regarding the ability of doctors/service officers to convey information about problems or obstacles obtained at the hospital including facilities and other unwritten rules, So even though it has been prepared in such a way, the risk still occurs.