Medical Malpractice Liability Research Articles

Criminal Liability Arising from Medical Malpractice on Patients: A Review from the Perspective of Positive Law And Islamic Law

The suspicion in cases of medical malpractice in is only slightly raised, meanwhile, there are actions by the health profession by doctors as medical personnel which have the potential to be a malpractice that can be reported by the public, but are not resolved legally because the community only has limited knowledge of science medical and because there is no form of specific legal regulations governing malpractice in Indonesia so that the occurrence of these malpractices can cause legal problems. This study aims to determine criminal liability for medical malpractice acts committed by doctors to patients in anticipating and dealing with medical malpractice problems in criminal cases. The research method used in this study is doctrinal, where the author collects material from the literature, both hardcopy and softcopy, which is related to the title of this research by using an analysis of the research object. Criminal malpractice occurs when a patient dies or is disabled and/or seriously injured as a result of actions taken by health workers who are careless or less careful in making efforts to treat patients who die or are disabled and are criminally liable as a result of medical malpractice acts committed. doctors on patients can be accounted for under Article 359 and Article 360 of the Criminal Code. In this case the health law is considered insufficient and does not clearly regulate the crime of medical malpractice. So it is necessary to regulate the crime of medical malpractice by giving birth to a new health law, namely by explicitly regulating criminal liability for medical malpractice acts by doctors against patients in Indonesia.

Variations of the Traditional Life Care Plan

A staple in assessing and valuing injury and related monetary damages claims, life care plans have traditionally encapsulated damages computations associated with present and anticipated future rehabilitation interventions related to contested events, the most common involving personal injury, medical malpractice, and product liability. The needs and sophistication of the injury claims assessment process have continued to evolve since the inception of life care plans, and accordingly affect the services life care planners contribute to resolve disputes over the need for and value of litigated future rehabilitation interventions. After a brief history and overview of life care planning, this article describes how the discipline evolved to its current state. The authors then discuss how lawyers’ discernments in prosecuting cases have led to the need for three variations/derivatives of the traditional life care plan: the life care plan cost comparison, the interpolated life care plan, and the international life care plan. Standards of practice considerations follow. According to the Commission on Rehabilitation Counselor Certification, life care planning is a career pathway for certified rehabilitation counselors (CRCs). Rehabilitation counselors encounter a myriad of physical and psychosocial factors that affect the rehabilitation process. CRC certification and training prepares counselors to holistically address complex areas of rehabilitation following a catastrophic illness or injury. According to the Commission on Rehabilitation Counselor Certification (CRCC) Code of Ethics, CRCs have a responsibility to the public to engage in practices that are based on accepted research methodologies and evidence-based practices. They need to remain current with developments in evidence-based practice. Notably, the three variations/derivatives of the traditional life care plan presented in this article address pertinent standards of practice considerations.

Medical malpractice liability in large language model artificial intelligence: legal review and policy recommendations.

The emergence of generative large language model (LLM) artificial intelligence (AI) represents one of the most profound developments in healthcare in decades, with the potential to create revolutionary and seismic changes in the practice of medicine as we know it. However, significant concerns have arisen over questions of liability for bad outcomes associated with LLM AI-influenced medical decision making. Although the authors were not able to identify a case in the United States that has been adjudicated on medical malpractice in the context of LLM AI at this time, sufficient precedent exists to interpret how analogous situations might be applied to these cases when they inevitably come to trial in the future. This commentary will discuss areas of potential legal vulnerability for clinicians utilizing LLM AI through review of past case law pertaining to third-party medical guidance and review the patchwork ofcurrent regulations relating to medical malpractice liability in AI. Finally, we will propose proactive policy recommendations including creating an enforcement duty at the US Food and Drug Administration (FDA) to require algorithmic transparency, recommend reliance on peer-reviewed data and rigorous validation testing when LLMs are utilized in clinical settings, and encourage tort reform to share liability between physicians and LLM developers.

Aggregating Liability for Medical Malpractice

Aggregating Liability for Medical Malpractice

Informed consent in urology

Appropriate professional practice includes the diagnostic and treatment process of urologic pathology, as well as patient information and respect for patient autonomy in decision making. Informed consent is the gradual process of providing information to the patient and their subsequent decision making. The informed consent document (ICD), when required, demonstrates that information has been provided sufficiently in advance to allow for the patient’s deliberation. The dual need for simple yet complete documents make the preparation of adequate ICDs extremely difficult. If the information process is not carried out properly, the professional may incur a medical malpractice liability that is treated as a loss of opportunity. To avoid such situations, the work of scientific societies in the preparation, accessibility, and dissemination of ICD models is fundamental.

Developing Safe Harbors to Address Malpractice Liability and Wasteful Health Care Spending

This Viewpoint discusses the feasibility of developing safe harbors that account for the role of medical malpractice liability and go beyond generic guidelines discouraging the overuse of health care resources.

El consentimiento informado en urología

Appropriate professional practice includes the diagnostic and treatment process of urologic pathology, as well as patient information and respect for patient autonomy in decision making. Informed consent is the gradual process of providing information to the patient and their subsequent decision making. The Informed Consent Document (ICD), when required, demonstrates that information has been provided sufficiently in advance to allow for the patient's deliberation. The dual need for simple yet complete documents make the preparation of adequate ICDs extremely difficult. If the information process is not carried out properly, the professional may incur a medical malpractice liability that is treated as a loss of opportunity. To avoid such situations, the work of scientific societies in the preparation, accessibility, and dissemination of ICD models is fundamental.

Analysis of medical malpractice liability disputes related to novel antineoplastic drugs and research on risk prevention and control strategies.

To investigate the general characteristics of litigation cases of medical malpractice liability disputes (MMLDs) related to novel antineoplastic drugs (NADs), the drugs involved, as well as the common types of medical errors related to NADs and their damages in the process of diagnosis and treatment, with the aims of improving the level of rational medication use in the clinical application of NADs and actively prevent medical disputes. The China Judgments Online was searched for the cause of action using the key word "MMLDs" along with the name of 77 kinds of NADs. A total of 39 NAD litigation cases meeting the inclusion criteria from 1 January 2009 to 31 December 2021 were analyzed, and each potential adverse drug reaction (ADR) was reviewed to determine a causality assessment using the Naranjo algorithm for non-drug-induced liver injury (DILI) cases and the updated Roussel Uclaf Causality Assessment Method (RUCAM) for the DILI cases. Risk prevention and control strategies were recommended. Cases that met the inclusion criteria increased substantially each year during the last six years, from three cases in 2009-2015 to 36 cases in 2016-2021. There were more cases in Eastern China than in other geographic regions. Most cases involved tertiary hospitals, patients between 25 and 60 years of age, and patients who were predominately male. There were 18 kinds of NADs involved in medical errors. The most common consequences of NADs were closely related to the death, disability, and increased treatment costs caused by ADRs, inadequate indications, delayed diagnosis and treatment, and misdiagnosis and mistreatment. The most frequent medical errors were medical technology errors, medical ethics errors and medical record writing/safekeeping errors. In two cases involving DILI, one case was unable to undergo further RUCAM scoring because the liver function indicators of the patient before and after treatment were not published. The establishment of mechanisms to reduce the risks associated with the clinical application of NADs is warranted. Healthcare services must maintain strict adherence to the specific requirements of GPCANADs and drug instructions and strictly grasp the indications, contraindications, usage, and dosage of drugs, and strengthen the notification and management of off-label drug use. Monitoring patients for ADRs and preparing rescue and treatment measures for high-risk drugs may serve to reduce damages related to NADs. For DILI cases, medical and appraisal institutions should use RUCAM score to assess causal relationships.

Telemedicine and the standard of care: a call for a new approach?

Telemedicine, understood as the provision of health care by a health professional to a patient who is physically not in the same location as the health professional, has many actual and potential benefits. It also has some disadvantages though, including a higher risk of misdiagnosis or another unfavorable outcome of certain remotely-provided services. In principle, the regime of legal liability for medical malpractice is the same for telemedicine as for traditional physical care. The general outline of the standard of care, which includes respect for medical science, the patient's individuality and objective possibilities, is abstract and flexible enough to be used for remote care without the need for redefinition. The quality of health care should be evaluated on the basis of the whole scale of risks and benefits it brings to a particular patient, including accessibility and comfort. In general, it should be permissible to provide a medical service remotely on the condition that its overall quality is at least as good as its comparable physical alternative. In other words, certain decrease in quality of some aspects of remote care can be compensated by other advantages. In terms of public health, support for telemedicine may bring a great improvement in the access to health care, and thus help significantly the individual members of the population. From the individual perspective, respect for personal autonomy implies that a patient should have every right to opt for a remote service, provided that there exists a true choice between meaningful options which is made on the basis of full information. If telemedicine is to fulfill its potential without sacrificing the protection of patients and their rights, reasonable guidelines for remote services need to be defined for particular medical fields, and for specific procedures within them. Among other issues, these guidelines must address the question of when it is necessary to refer the patient to physical care.

Criminal and Civil Aspects Of Healthcare Worker Liability For Medical Malpractice in Croatia

A healthcare worker's liability for damage caused to patients can be criminal, civil, misdemeanour, and disciplinary, with the necessary precondition that the damage was caused as a result of medical malpractice or negligence, and not as a result of the regular course of the disease. The paper analyzes the criminal law and civil law aspects of the healthcare worker's responsibility for damage caused by medical malpractice through the provision of medical care. The imprecise definition of the legal nature of the healthcare worker's responsibility, the obligations that the law imposes on doctors, the definition of malpractice in medical treatment, as well as the legal basis of responsibility, indicate the existence of many legal dilemmas that require additional analysis to which we would like to contribute with this paper. Because of a broad concept of issues in healthcare worker's liability, this paper aims to explain the material assumptions of criminal (duty to act) and civil (negligence) liability and discusses the legal position of a medical expert in both types of proceedings.

Malpractice liability and defensive medicine in anesthesia: Egyptian anesthesiologists’ perspectives

ABSTRACT Background The threat of malpractice liability could alter anesthesiologists’ clinical attitudes and behavior leading them to practice defensive medicine (DM) which aims at protecting doctors from medicolegal claims. Purpose To explore the knowledge, attitude, and practice of Egyptian anesthesiologists towards DM and their attitude and previous experience regarding medical malpractice liability. Methods An online cross-sectional questionnaire was done on a convenience sample of anesthesiologists. The questionnaire involved physician data, knowledge, attitude, and practice regarding DM, their attitude and previous experience regarding medical malpractice liability, and justifications for practicing DM. Results The questionnaire was completed by 177 anesthesiologists. Only 10.7% of participants received training about malpractice liability. The concern of malpractice litigation was reported by 81.4% and 92.1% of participants thought that malpractice lawsuits will have a negative influence on their performance. Most of the anesthesiologists (70.6%) reported that at least one of their colleagues was named in malpractice lawsuits, while 32.7% of them reported being investigated for malpractices. Based on “Defensive Medicine Behavior Scale”, 61% of the participants had a very high score. The highest reported justification for DM was fatigue 27.7%. Conclusions Despite the fact that more than half of the participants’ knowledge of DM was insufficient, about 61% had a very high score for DM-related behaviors. This highlights the DM current situation among them which could endanger physicians’ proficiency, quality of care, patient rights, and cost. Efforts with medicolegal training should be made to keep physicians' risk perception and anxiety in balance to avoid DM.

صور الخطأ الطبي في المسؤولية المدنية وفقًا للقانون الأردني

Abstract Medical profession is one of the most important human professions, since doctors’ duties are to treat patients who put their bodies at the disposal of the physician to get rid of the pain they suffer from. Indeed, this may sometimes require surgical intervention, in which the patient’s life may depend on. Therefore, the practice of this profession imposes a legal duty besides a humanitarian one. As the doctor must render the necessary care and service for patients due to principles and rules of medical profession. However, the doctor may not adhere to the rules and principles of the medical practice when treating patients, this is when the doctor makes an error and he/she could face legal liability for medical malpractice. This research presents the nature of this error in terms of its concept, conditions, and legal standard. It also tackles its different forms in regard to its relation with medical profession, or to different stages of treatment. Keywords: forms of malpractice, medical malpractice, civil responsibility.

Inferior Vena Cava Filter Litigation Review: An Analysis of Medicolegal Cases Pertaining to Inferior Vena Cava Filters

PurposeTo identify and analyze all medical malpractice and product liability lawsuits pertaining to inferior vena cava (IVC) filters published within a well-recognized legal research database. Materials and MethodsLexisNexis, a legal research database, was used to retrieve cases that mentioned harm from IVC filters, or lack thereof, as the cause for legal action. A total of 672 cases were analyzed for type of case (medical malpractice or product liability), filter model implanted, filter complications, court decisions, and settlement payments if any. ResultsOf 95 analyzed cases, 20 (21.1%) were medical malpractice cases and 75 (78.9%) were product liability cases. C.R. Bard was the manufacturer associated with the most lawsuits (n = 41, 48.8%). The most litigious filters were the G2 filter from C.R. Bard (n = 17, 20.2%) and Greenfield filter from Boston Scientific (n = 17). The most common complications were IVC penetration (n = 26, 29.9%), filter migration (n = 26, 29.9%), filter fracture (n = 23, 26.4%), and tilt (n = 16, 18.4%). The number of product liability cases has increased from accounting for 25.0% (2 of 8) of filter lawsuits between 2000 and 2010 to 83.9% (73 of 87) during 2011–2020. Of the 20 medical malpractice claims, 9 (45%) were filed for failure to place a filter. One physician was found liable for filter-related complications by a state court in 2014. ConclusionsThe majority of recent IVC filter–related lawsuits are filed against manufacturers on the basis of product liability claims, with the main litigious filters being the G2 and Greenfield filters. Most cases resulted in rulings for physicians or manufacturers. Some were filed against physicians for filter-related complications or for failure to place an IVC filter.

When Artificial Intelligence Models Surpass Physician Performance: Medical Malpractice Liability in an Era of Advanced Artificial Intelligence.

It seems inevitable that diagnostic and recommender artificial intelligence models will ultimately reach a point when they outperform human clinicians. Just as antibiotics displaced a host of medicinals for treating infections, the superior performance of such models will force their adoption. This article contemplates certain ethical and legal implications bearing on that adoption, especially because they involve a clinician's exposure to allegations of malpractice. The article discusses four relevant considerations: (1) the imperative of using explainable artificial intelligence models in clinical care, (2) specific strategies for diminishing liability when a clinician agrees or disagrees with a model's findings or recommendations but the patient nevertheless experiences a poor outcome, (3) relieving liability through legislation or regulation, and (4) comprehending such models as "persons" and therefore as potential defendants in legal proceedings. We conclude with observations on clinician-vendor relationships and argue that, although advanced artificial intelligence models have not yet arrived, clinicians must begin considering their implications now.

What are the health consequences associated with differences in medical malpractice liability laws? An instrumental variable analysis of surgery effects on health outcomes for proximal humeral facture across states with different liability rules

BackgroundStates enacted tort reforms to lower medical malpractice liability, which are associated with higher surgery rates among Medicare patients with shoulder conditions. Surgery in this group often entails tradeoffs between improved health and increased risk of morbidity and mortality. We assessed whether differences in surgery rates across states with different liability rules are associated with surgical outcomes among Medicare patients with proximal humeral fracture.MethodsWe obtained data for 67,966 Medicare beneficiaries with a diagnosis of proximal humeral fracture in 2011. Outcome measures included adverse events, mortality, and treatment success rates, defined as surviving the treatment period with < $300 in shoulder-related expenditures. We used existing state-level tort reform rules as instruments for surgical treatment and separately as predictors to answer our research question, both for the full cohort and for stratified subgroups based on age and general health status measured by Charlson Comorbidity Index and Function-Related Indicators.ResultsWe found a 0.32 percentage-point increase (p < 0.05) in treatment success and a 0.21 percentage-point increase (p < 0.01) in mortality for every 1 percentage-point increase in surgery rates among patients in states with lower liability risk. In subgroup analyses, mortality increased among more vulnerable patients, by 0.29 percentage-point (p < 0.01) for patients with Charlson Comorbidity Index > = 2 and by 0.45 percentage-point (p < 0.01) among those patients with Function-Related Indicator scores > = 2. On the other hand, treatment success increased in patients with lower Function-Related Index scores (< 2) by 0.54 percentage-point (p < 0.001). However, younger Medicare patients (< 80 years) experienced an increase in both mortality (0.28 percentage-point, p < 0.01) and treatment success (0.89 percentage-point, p < 0.01). The reduced-form estimates are consistent with our instrumental variable results.ConclusionsA tradeoff exists between increased mortality risk and increased treatment success across states with different malpractice risk levels. These results varied across patient subgroups, with more vulnerable patients generally bearing the brunt of the increased mortality and less vulnerable patients enjoying increased success rates. These findings highlight the important risk-reward scenario associated with different liability environments, especially among patients with different health status.

PERTANGGUNGJAWABAN PERDATA MALAPRAKTIK MEDIK

This paper aims to discuss civil liability for medical malpractice. The patient's alleged insanity is often considered the negligence of the doctor in carrying out medical actions. The paradigm is getting stronger with increasing reports of medical malpractice every year. Doctors in performing medical treatment of patients are based on a bond or relationship in the agreement. The bond or relationship in the agreement is called inspannings verbentenis or maximal effort engagement. The existence of this shows that the main obligation of a doctor is to do a hard effort that must be done and needed to support the patient. This can be based on the standards of the medical profession and its operational standart as stipulated in article 50 juncto 51 of Law No. 29 of 2004 concerning the Practice of Medicine. The methods used in this study are juridical-normative with a statutory approach. The result obtained is civil liability in a medical malpractice arises if there is wrong treatment from the doctor in relation to providing medical service performance and the patient suffers losses for the doctor's actions. Legal liability in the civil domain is generally realized in the form of compensation or compensation by doctors or hospitals with due regard to the principles of liability. The right of patients in demanding compensation is regulated in Article 58 of Law No. 36 of 2009 on Health and Article 32 of Law No. 44 of 2009 concerning Hospitals.&#x0D; &#x0D; Keywords: Liability, Civil, Medical Malpractice

Legal imperatives of medical negligence and medical malpractice

Medical negligence and malpractice are becoming a growing concern in Nigeria; even though many victims do not know how to go about seeking redress or demand justice, medical practitioners, too, do not understand the legal implications of their actions. Medical negligence and malpractice are tortious liabilities that can also result in criminal liabilities. It is a fact that health-care practice will occasionally result in circumstances where health seekers suffer some distress or permanent injury in the course of handling by medical practitioners. This distress or injury can be a result of either commission or omission due to the actions or inactions of the medical practitioner. This review was embarked upon using thoroughly studied recent and older literature concentrating on research indications resulting from the fields of medicine and law within and without Nigeria. Common acts that could give rise to lawsuits on medical negligence and medical malpractice include doctor's illegible handwriting, prescription and medication errors, misdiagnosis or failure to diagnose, improper medical treatment, leaving surgical instruments in patients after surgery, lack of informed consent, failure to refer a patient to a specialist, breach of confidentiality, extortion, and deception among others. For liability to come up in negligence, it is imperative that the three main fundamentals of negligence, which include that a duty of care is owed, there was a breach of the duty of care, and injury or permanent disability suffered as a direct consequence of a breach of the duty of care must be well established and proved beyond a reasonable doubt. The inability of a victim to successfully prove a case of negligence against a medical practitioner does not totally absolve a practitioner from charges related to other offences under other aspects of the law, hence the fact that negligence is difficult to prove does not leave a patient deprived of other legal opportunities as may be considered appropriate. Even though the law protects the medical practitioner to the level that liability for medical negligence and medical malpractice has to be proved beyond a reasonable doubt, much more legal protection is needed to allow medical practitioners to discharge their duties of saving lives. Medical practitioners need to be aware of their limits as well as the legal implications of their work; this can be achieved by incorporating medicolegal principles into medical education for medical students, as well as periodic medicolegal lectures for medical practitioners.

Implementing Live Virtual Surgery in the COVID Era: Overcoming Medicolegal, Technical, and Educational Hurdles.

Due to current health concerns related to the coronavirus disease of 2019, remote learning has been adopted at every academic level. In congruence with policies drafted by academic surgical societies, a majority of medical schools nationwide have decided against accepting visiting medical students.1,2 As such, there has been an emergence of virtual adaptations of educational sessions and clinical rotations across a variety of medical specialties.3,4 Because surgical education occurs primarily in the operating room, adopting a virtual model for surgical education presents distinct challenges. At the Yale School of Medicine, we designed the first virtual surgical rotation format to center around livestream plastic surgeries across key areas of the specialty.5 Successfully implementing this teaching modality required overcoming medicolegal challenges, the logistical and technical details involved in the creation of this educational modality, and educational hurdles. In coordination with the Yale School of Medicine and the Yale Graduate Medical Education office, the virtual rotation was registered as a formal course for credit through the Association of American Medical College’s Visiting Student Application Service, identical to in-person visiting electives. By formally registering for the virtual rotation through the Visiting Student Application Service, virtual rotators met the same medical malpractice liability coverage and Health Insurance Portability and Accountability Act requirements as in-person rotating subinterns. Many of the participating students used the virtual rotation toward clinical credit for their graduation requirements. In addition, patients completed written consent forms for the hospital and university, giving permission to livestream surgery. (See Document, Supplemental Digital Content 1, which shows the photographic consent form for patients agreeing to participate in the livestream surgery, https://links.lww.com/PRS/E735.) These steps enabled clinical information to be shared freely with students in a remote learning environment. The technical challenges included high-quality visual capture of the surgery, real-time transmission to enrolled students, and real-time interactive communication between students and the surgical team. For image capture, we utilized a high-definition resolution, loupe-mounted camera with two-times and three-times magnification options. Loupe magnification enabled optimal macro image transmission for viewing of detailed surgical anatomy. For more macroscopic surgeries, a nonmagnified camera would be preferable. The high-definition camera captured images onto a computer that livestreamed images to the virtual participants using a Zoom platform (Zoom Video Communications, San Jose, Calif.) with password protection. To enable real-time two-way communication, speakers were strategically placed in the operating room to allow faculty and students to continuously discuss the case (Figs. 1 and 2).Fig. 1.: Setup of the live-stream surgery, with images transmitted to participants via Zoom, with password protection and communication between surgeon and applicants in real time.Fig. 2.: High-definition resolution, loupe-mounted camera was used for the video streaming of the procedures from the surgeon point of view.The virtual surgery curriculum included one live surgery per day spanning the breadth of plastic surgery, which replicated many of the benefits of being physically present in the operating room. Students could view a surgery step by step from the attending’s viewpoint. In addition, a multitude of students can simultaneously participate in the same case, unlike with in-person rotations. Participants were able to reference case-relevant study materials during the operation, which may enhance understanding of the procedure. The development of live virtual surgery poses some initial challenges, but ultimately it can be replicated with ease to create a surgical rotation more authentic to the in-person experience as pandemic restrictions continue. By elucidating the process by which we implemented livestreamed surgeries, other interested institutions will be able to easily traverse the necessary medicolegal and technical aspects of constructing similar models.

Teamwork in health care and medical malpractice liability: an experimental investigation

Teamwork in health care and medical malpractice liability: an experimental investigation

Medical Malpractice Liability in the United States of America in the Light of the 19th Century Origins of the American Legal System

The American model of medical malpractice liability has been the subject of lively public and scientific debate for years. This system is characterized by a large number of lawsuits against doctors and very high damages awarded in such cases. In turn, these phenomena contribute to the occurrence of so-called medical malpractice crisis. It seems that an important place in the proper understanding of the American model of physicians’ liability for medical malpractice may be the historical analysis of legal norms regulating this matter. The text claims that the modern specificity of the system of liability for medical malpractice is closely related to the development of American law in its formative period in the nineteenth century. The article indicates four features of the legal system developed at that time, which today are identified as responsible for a large number of lawsuits and high compensation in malpractice trials. These include, in particular, linking medical liability to the tort law regime, domination of the civil law dimension of liability for medical errors, the role of the jury in lawsuits for medical malpractice, and the method of remuneration of attorneys in such cases.