[Medical history studies on the problem of medical malpractice and medical liability. A 19th century medical law regulating medical liability questions].
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Radiologists are liable for all aspects of their practice, from the indication of an examination to the radiology report and follow-up, as well as for providing information and recommendations. They are liable for their decisions and actions. They are liable for their competence and continuous medical education. They are also liable for their own equipment and staff. In cases of litigation, the liability of a radiologist may be questioned. Four types of procedures must been known: penal, civil, administrative and disciplinary.
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A new Florida medical liability insurance act went into effect on February 8, 1988. It would allow for prompt resolution of claims with mandatory presuit investigation of all claims and defenses and voluntary arbitration. A cap of $250,000 is placed on noneconomic damages without punitive awards. Refusal to arbitrate leads to a loss on limit on damages awardable at trial. Special provisions are made for birth-related neurological injury compensation.
BACKGROUND: Medical malpractice claims against surgeons are increasing. In Germany, as in most other European countries, there is no central registry of medical malpractice claims. It is not known at which rate medical liability claims are decided in favor of the physician or the patient. METHODS: All cases of reproaches of medical malpractice in which our clinic was involved within the 10-year period between 1989 to 1999 were reviewed. To compare our results with the general experience in the field of thoracic and cardiovascular surgery, we reviewed the data of the regional medical society in the same time period. RESULTS: From 1989 to 1999, our Clinic was involved in 74 medical liability disputes. There were 28 reproaches of medical malpractice against our department (0.1% of cases performed). Malpractice was detected in only 7 of 74 claims (9.5%). Most reproaches were made for incorrectly performed operations (80%), but only 4 (6.8%) of 59 claims were regarded as medical malpractice. CONCLUSIONS: Reliable data on reproaches of medical malpractice are virtually absent. Only 10% of all reproaches in our study were finally regarded as medical malpractice. A central registry of medical malpractice cases would allow analysis of the areas in which we have to improve performance, and how unjustified reproaches of medical malpractice can be avoided.
Over the past few years, the traditional paper-based medical record system has come under close scrutiny by every participant in the healthcare industry. Some groups, especially federal agencies such as Medicare and Medicaid, HMOs, and other third party payors, have begun to demand changes in medical record documentation, and have become very assertive as to what goals and objectives will be met. In contrast, the medical liability insurance industry has remained almost invisible during this period of transition. At a recent electronic medical records (EMR) conference participants attending a software development workshop were asked if they had their systems reviewed from a medicolegal standpoint by a malpractice insurance carrier. In response to this inquiry, not one software vendor raised their hand to indicate this had been accomplished, or was even contemplated. In the author's opinion, the key missing factor in the current quest for a paperless medical office system rests in the domain of those who represent the medical liability industry. All of these gate-keepers of medical loss and risk prevention will eventually be called upon, either by choice or necessity, to validate every working EMR system that is used in medical practices in the future. This article will explore the best information published from this currently silent sector of the industry, and proposes an active involvement by the medical liability industry in the current EMR design and development processes taking place. In addition, there are 10 minimum EMR design criteria contained in this article that are recommended for implementation based upon 16 years of medical malpractice experience and loss prevention input.
Since mid-1993, all ECT treatments performed in the state of Texas (except for United States government hospitals) must be reported every quarter to the Texas Department of Mental Health and Mental Retardation (TXMHMR) on a data collection form provided by the Department. Part 1 of this paper reviewed that data. This paper reviews the responses to questionnaires and contacts made with physicians, hospitals, medical liability insurance companies, and manufacturers of stimulus generating devices regarding their experience with ECT in Texas. Questionnaires were sent to physicians and hospitals that had not performed ECT during the final two quarters of the review period. Medical liability insurance companies and the manufacturers of the stimulus generating equipment used in ECT were contacted regarding their experience with liability claims. The results indicate that medical liability in regards to the performance of ECT is extremely low. Physicians and hospitals that stopped performing ECT did so for reasons other than medical liability.
Political debate over medical malpractice reform seldom takes meaningful account of its policy context, including the emerging science of patient safety. Instead, stakeholders on both sides use the rhetoric of patient safety to support entrenched positions on hardened proposals such as capping damages and limiting access to information about errors. Despite its déjà vu quality, the current malpractice crisis can only be understood and addressed as the product of changes in the health care system since the last crisis nearly twenty years ago--changes that also informed the patient safety movement. Patient safety may therefore serve as a bridge between medical liability and health policy.
The principal legal resolutions about medical liability lawsuits in Chile are analyzed. The causes for the accusations and for the increase in the number of suits in Chile, according to research performed by the authors, are described. An improvement in patient-physician relationships, a better alliance among physicians, a correct certification of medical specialties, the demand of adequate technological and humans resources to perform medical functions optimally, the supervision of medical work and the legal support and advice of medical societies are recommended strategies to prevent these lawsuits.
Although the direct costs of the medical liability system account for a small fraction of total health spending, the system's indirect effects on cost and quality of care can be much more important. Here, we summarise findings of existing research on the effects of the medical liability systems of Australia, the UK, and the USA. We find systematic evidence of defensive medicine--medical practice based on fear of legal liability rather than on patients' best interests. We conclude with discussion of four avenues for reform of traditional tort compensation for medical injury and several suggestions for future research.
Automated anesthesia record-keeping systems (AARKs) are increasingly being used. There is a perception that AARKs may limit medical liability. We report a case in which our AARK may have increased our medical liability exposure. Nine months after a patient suffered a serious intraoperative complication, the anesthesiologist was named (as one of several defendants) in a claim alleging failure to properly monitor anesthetic care. One reason why the anesthesiologist was named related to a gap of 93 min in which no vital signs were documented in the anesthesia record. Relying on the physiological monitors to assess the patient's condition, the anesthesiologist did not recognize the interruption of data transmission, because the "active" medication window obscured the graphical display of the vital sign window.