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Malpractice liability of physicians to nonpatients.

Sometimes physicians assume responsibilities to third parties when undertaking the care of patients. Physicians have been held liable to third parties, though strangers to the patients, for failing to warn regarding the communicability of contagious diseases. Two suits have been allowed against physicians by third parties who were injured by drivers of vehicles who had not been warned by the physician of the danger of driving caused by their medical problem. Hospitals and psychiatrists have been held liable to injured third parties for failing to warn of the dangerous propensities of their patients under psychotherapy. Courts have held that such disclosures do not violate the patient's right to privacy and confidentiality. However, physicians may exercise professional discretion and need not warn if, in their judgment, that would be unreasonable, unnecessary, or harmful. Nevertheless, rights of patients must yield to the public interest when it collides with public safety and welfare.

Confidentiality↗

Malpractice claims.

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Diagnostic Errors↗

A description of emergency department-related malpractice claims in The Netherlands: closed claims study 1993-2001.

BACKGROUND: The aim of this study was to assess the quality of care provided at emergency departments (ED) in the Netherlands by analysing medical liability insurance claims. METHODS: A retrospective study performed by reviewing records at MediRisk, presently the largest insurer for medical liability in the Netherlands. The following data were abstracted from the files available for analysis: medical discipline involved, physician involved (resident or consultant), nature and gravity of the complaint, and final claim disposition. RESULTS: Between 1993 and 2001 a total of 326 claims involving the ED were filed at MediRisk. Of these, 256 claims (79%) were closed and were available for analysis. Medical liability claims were filed primarily for alleged errors in diagnosis and treatment. The majority of claims involved minor surgical conditions: fractures, luxations (joint dislocations), wounds and tendon injuries (210/256, 82%). Residents were involved in 76% of the claims; resident supervision by a consultant was documented in only 15% of the medical records. Permanent patient disability resulting from improper ED treatment was alleged in 22% of the claims. Four per cent of the claims involved the death of a patient. Physicians accepted liability in 16% of the claims filed. Indemnity payments during the 8-year study period totalled Euros 504,000. CONCLUSION: The number of medical liability claims is low compared with the number of patients treated in ED in the Netherlands. Claims primarily concerned alleged mistakes in diagnosis and the treatment of minor trauma. Residents were involved in the majority of the claims. More resident supervision is needed, as are specific training programmes for emergency physicians.

Emergency Medicine↗