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Medical malpractice and cancer of the skin.

BACKGROUND: A litigation crisis exists in this country, and it may be better understood through analysis of lawsuits. Verdict summary analysis has been used for this purpose. METHODS: Ninety-nine jury verdict reviews from 1986 to 2001 were obtained from a computerized database. Reviews compiled data on defendants, plaintiffs, allegations of wrongdoing, cancer cell types, sites, outcomes, and case summaries. Data was entered into a spreadsheet for analysis. RESULTS: Failure to diagnose was alleged in 54%; of these, 48% alleged biopsies were inappropriately omitted. Allegations were highest for failure to diagnose in dermatologists and general practice physicians, for misdiagnosis in pathologists, and for complications in surgeons. Young patients and those with poor outcomes received more and larger awards. Trauma appears to have support for a role in causation of skin cancer in some courts. CONCLUSIONS: The study of skin cancer suits may help develop risk management and prevention strategies.

Adult↗

Medical malpractice of prostate brachytherapy.

PURPOSE: To summarize the basis for brachytherapy-associated legal complaints. METHODS AND MATERIALS: The cases summarized here were those worked on by one author (KW) from 1992 through 2002. Summary information about cases is kept solely for the purpose of informing opposing counsel regarding past experience as a defendant or expert witness. No information summarized here is kept for medical research purposes. KW was the defendant in three cases, and an expert witness in the remaining 10 cases. RESULTS: Eleven cases were initiated due to a prostatic-rectal fistula--an abnormal communication between the prostatic urethra and rectum formed because of breakdown of irradiated tissue. Of the cases not involving a fistula, one was initiated due to chronic urinary burning, and the other arose from a patient identification mix-up, such that the plaintiff was treated with the implant planned for another patient. The principal physician defendant(s), after pre-trial winnowing, was the radiation oncologist alone in eight cases and the radiation oncologist and the urologist in five cases. In no case was a urologist named as a defendant without the radiation oncologist. None of the eleven rectal fistula cases involved an egregious seed placement error. Instead, plaintiff attorneys typically claimed breach of standard for care for what most physicians would likely consider to be variations within the standard of care. CONCLUSION: Prostate brachytherapists should brace themselves for the likelihood of more lawsuits. In addition to fistulas, plaintiff attorneys are likely to devise more bases for lawsuits in the future.

Brachytherapy↗

Malpractice crisis and reform.

Medical liability coverage has become increasingly expensive and scarce since 2001, especially for obstetrics and other high-risk specialties. Physicians, whose own fees are constrained, see this as a crisis needing tort reform to cap payouts. Plaintiffs' lawyers fight caps; they blame insurance trends and call for stronger regulation of insurers and physicians. Doctors' arguments are somewhat better than lawyers' about insurance developments, but the huge tort reform battle wholly ignores the biggest problems--the medical system has too many preventable medical injuries, and the legal system fails to prevent them. It is time to try out better approaches, three of which are discussed in this paper.

Compensation and Redress↗

Epidemiological case survey of medical malpractice in some medical and surgical specialties.

According to the common view held by the general public, doctors can never make professional mistakes, as if by virtue of their profession they were bound to be infallible. Moreover, when mistakes do occur in the medical field they are seen in a personal light, being attributed to an individual professional figure who is expected to answer for them in both the penal and the civil field. In this paper, the authors made a retrospective analysis of 37 of all the 725 legal suits filed in some hospitals of the Apulian region (South Italy) during the period between 1991 and 2000, being all those lodged against operators in the neurological, urological, otorhino-laryngoiatric and cardiosurgical fields, recorded in the Archives of the Health Services of Bari, Brindisi, Lecce and Taranto or in those of our Forensic Department following consultations on medical and surgical responsibility.

Female↗