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This paper delves into the intricate relationship between the evolving field of genomic medicine and healthcare providers' legal and ethical responsibilities, with a particular focus on the duty to warn in the context of genetic risks. Through a critical examination of landmark cases such as Pate v. Threlkel and Safer v. Estate of Pack, this study underscores the expanding scope of healthcare providers' duties to include not just the patient but potentially at-risk family members as well. It highlights the legal, ethical, and practical challenges that arise when balancing patient confidentiality with the need to prevent harm through the disclosure of genetic information. The descriptive portion of the paper outlines the current legal precedents and the ambiguity surrounding healthcare providers' responsibilities. The prescriptive portion proposes the establishment of comprehensive, clear guidelines to support healthcare providers, particularly genomic counselors, in navigating these complexities. This includes recommendations for policy changes and the development of protocols that respect patient autonomy while addressing the preventive potential of genomic medicine. Through an analysis of legal frameworks and ethical considerations, this paper argues for a nuanced approach that equitably balances individual rights with the collective good, ultimately advocating for a future where genomic medicine is integrated into patient care in an ethically responsible and legally sound manner.

Using network analysis, we study referrals among plaintiff‐side lawyers handling medical malpractice cases in Indiana. The referral network is stratified, with a few highly connected "hub" firms. Firm connectivity follows a power law distribution—suggesting that new entrants tend to associate with already well‐connected firms, rather than starting a new network. Regression analysis shows that, for a given firm, connectivity (i.e., node degree) in the referral network and being loyal to a smaller number of firms both lead to better outcomes in non‐referred cases. The referral network also became more concentrated over time. The stratification of the market for plaintiff‐side representation is reinforced through these processes. [ABSTRACT FROM AUTHOR]

Copyright of Egyptian Journal of Forensic Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hypernatremia is an increase in serum sodium concentration above 145 mmol/L. There are many causes of elevated sodium levels in the blood serum. One is incorrect actions performed by medical staff. The symptoms of excessively high serum sodium levels depend on the severity of hypernatremia, the rate of its increase and the accompanying volume disorders. Severe symptoms include altered consciousness, increased muscle tone and reflexes, convulsions, psychomotor hyperactivity or drowsiness (up to coma), respiratory failure, and even death. We present the case of a 45‐year‐old man who took seven tablets of a blood pressure‐lowering drug, and paramedics subsequently administered a concentrated solution of table salt to induce vomiting. However, vomiting did not occur, leading to hypernatremia. Ultimately, the man survived but developed persistent cognitive dysfunction, including disordered short‐term memory and encoding and retrieval of information from long‐term memory, weakening of attention function and fatigue, and disorders in abstract thinking. The patient's family went to the prosecutor's office to investigate the possibility of medical malpractice. Experts found that the paramedics' actions were incorrect. Although it has been known for many years that table salt solutions should not be used to induce vomiting, unfortunately, both laypeople and medical professionals are still using this technique. Iatrogenic salt poisoning may end not only in serious health complications but also in legal consequences. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chengdu University (Social Science) is the property of Journal of Chengdu University (Social Science Edition) Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medical negligence, a negligence by the living God, not only common now a days but have become one of the serious issues in India even in whole world. Medical profession, though one of the noblest professions, is not immune to negligence which as a results complete / partial impairment or culminates into another misery or even sometimes death of patient. The magnitude of negligence or deliberate conduct of the medical professionals has many times led to litigation. To carry out this profession with all the care and responsibility towards the patients, doctors are bound with the Oath. However due to rising cases of Medical Negligence in present scenario, it seems that medical practice has become more of a commercial industry resulting into mishandling of the lives of patients who rests their belief and trust with their treating doctor. The aim is to analyze the concept of negligence in medical profession in the light of interpretation of law by the Supreme Court of India with the help of BNS (Bhartiya Nyaya Sanhita or Indian Penal Code Act), MTP Law, tort. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Negligence is defined as doing something which reasonably competent people not suppose to do or not doing something which reasonably competent persons suppose to do. Present cross sectional study was undertaken with aim to assess knowledge and awareness of general population visiting Out Patient Departments (OPD) of Civil Hospital associated B. J. Medical College, Ahmedabad towards medical negligence and legal proceeding regarding medical negligence. Total 350 people from general population were subjected to pre-tested and pre-validated questionnaire related to medical negligence after obtaining their informed written consent. Questionnaire contain 16 questions related to medical negligence and legal proceeding regarding medical negligence with responses based on Likert's scale varied from strongly disagree to strongly agree. Responses obtained were tabulated in MS Excel sheet and analyzed via SPSS software. Out of 350 participants, 32.8% were between 31-40 years age group, 64% were male. Total 54% were agreed upon that failure to maintain a medical record by hospital is negligence. 65% were agreed that doctor can be liable for negligence. 67% were agreed upon that performing operation without informed written consent is negligence. 30% were agreed upon that treating a patient without his consent is negligence. 81% were strongly agreed upon that carelessly leaving an instrument in patient's body after operation is negligence. 49% were strongly agreed upon that refusing to attend patient in emergency is negligence. 57% were strongly agreed upon that death due to negligence is punishable by court. 44% were agreed upon that compensation for negligence can be claimed in consumer court. 53% were agreed about that wrong diagnosis followed by wrong treatment is considered as negligence. 50.5% of participants were agreed upon that postmortem is necessary in case of death due to medical negligence, while 34.8% were disagreed. All participants believed and agreed upon that threaten or attack on a doctor is punishable in court even if doctor is truly negligent. Present study reflected that general population has quite a good knowledge regarding medical negligence which may increase gradually over a period of time due to news papers, internet and other resources but less knowledge about legal proceedings regarding medical negligence. Training programs should be conducted for them to bring true knowledge and awareness regarding medical negligence which indeed helps to them as well as medical professionals. [ABSTRACT FROM AUTHOR]

Copyright of Angle Health Law Review is the property of Angle Publishing Co., Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Taiwan Law Review is the property of Angle Publishing Co., Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Being named as a defendant in a malpractice lawsuit is known to be a particularly high-stress and vulnerable time for a physician. Medical malpractice stress syndrome (MMSS) is a consequence of being named as a physician defendant in a malpractice lawsuit. Symptoms include depression, anxiety, and insomnia, which may lead to burnout, loss of confidence in clinical decision-making, substance abuse, strain on personal and professional relationships, and suicidal ideation. Although the legal process requires strict confidentiality regarding the specific details of the legal case, discussing the emotional impact of the case is not prohibited. Given that physicians often do not choose formalized therapy with a licensed professional, there is a recognized need to provide physicians with options to support their wellness during a lawsuit.Methods: The peer support model is a promising option to address the negative impacts to wellness that physician defendants face during medical malpractice lawsuits. We developed and implemented a peer support program to provide a safe, protected space for discussion of the personal impact of a lawsuit and to normalize this experience among peer physicians.Results: Physicians were receptive to joining a peer support group to discuss the personal impacts of being named in a medical malpractice lawsuit. Participants in this novel group-based program found it helpful and would unanimously recommend it to others who are being sued.Conclusion: To our knowledge, this pilot study is the first to implement and assess a facilitated, group-based peer support model for emergency physicians who are named as defendants in malpractice lawsuits. While group discussions demonstrated that symptoms of acute distress and MMSS were prevalent among physicians who were being sued, in this study physicians were receptive to and felt better after peer support sessions. Despite increasing burnout in the specialty of emergency medicine (EM) during the study time frame, burnout did not worsen in participants. Extrapolating from this pilot program, we hypothesize that formal peer support offered by EM groups can be an effective option to normalize the experience of being sued, promote wellness, and benefit physicians who endure the often long and stressful process of a medical malpractice lawsuit.

ABSTRACT Background Aims Methods Results Conclusions With the increasing demand for cosmetic procedures in recent years, the implementation of some of these procedures by unauthorized persons has led to undesirable results and subsequently to the creation of a large number of case files.In this study, it is aimed to retrospectively evaluate the decision texts of the Turkish Supreme Court regarding minimally invasive cosmetic dermatology procedures and to evaluate the reasons and results of the applications reaching the high court in these procedures.The Supreme Court's decisions in cases filed due to undesirable consequences caused by minimally invasive cosmetic interventions were scanned using the Supreme Court of Appeals' online database from 2013 to 2023.The majority of the procedures addressed by the lawsuits are carried out in beauty salons; laser epilation is the procedure that is conducted most frequently, and burns are the most prevalent complication (87.8%, 85.7%, and 77.6%, respectively). As an adverse event, 94.7% (n = 36) of burns occurred in beauty centers. Thirteen (26.5%) of the cases in our analysis were carried out by an unauthorized person. When laser epilation and other procedures are considered as two separate categories, in applications due to adverse events of laser epilation, 28 (66.7%) cases were concluded in favor of the defendant.Complications, especially burns, that occur after laser epilation performed by unauthorized persons in beauty salons constitute a serious caseload, and there seems to be a need for better control mechanisms to reduce this burden. [ABSTRACT FROM AUTHOR]

Recent years have witnessed significant developments in medical negligence jurisprudence. In 2015, the Supreme Court in Montgomery v Lanarkshire Health Board famously departed from the House of Lords decision in Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital by ruling that the professional practice test set out in Bolam v Friern Hospital Management Committee no longer applied to the doctor's duty to give advice to the patient. In particular, the Supreme Court in Montgomery held as follows: The doctor is ... under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. The test of materiality is whether, in the circumstances of the particular case, a reasonable person in the patient's position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it. [ABSTRACT FROM AUTHOR]

Cardiac tumors, especially malignant ones, are rare and diagnosis is challenging since symptoms manifest late and are often non-specific. Achieving a histological diagnosis prior to resection is also difficult because biopsies often fail to yield conclusive results. Due to the low frequency, no standard treatment protocol exists and the prognosis is poor. We present a case of a cardiac sarcoma, which was found during an autopsy performed with regard to medical malpractice, because the patient died due to a medical intervention. To report cases like this is important to gain more knowledge about possible complications regarding rare diseases. [ABSTRACT FROM AUTHOR]

The article cites reasons for the failure of tort reform in Florida. It discusses the proposed goals of the tort reform system and the legislature's methods to accomplish those goals. Tort reform methods for limiting medical malpractice insurance premium lawsuits include statutory presuit process, the Florida Birth-Related Neurological Injury Compensation Plan, limitation of recovery against state-run hospitals, limitation of how much an injured party may recover and cap on noneconomic damages.

Given high patient expectations in the setting of complex surgeries, orthopedic surgeons are at risk of being subject to malpractice claims which can impose significant economic and psychological burden. This study investigates malpractice claims against orthopedic surgeons and podiatrists performing hindfoot arthrodesis and determine factors associated with plaintiff verdicts and settlements using the Westlaw legal database. The database was queried for all cases involving hindfoot arthrodesis using the terms "malpractice" and either "ankle fusion," "arthrodesis," "subtalar fusion," "tibiotalar fusion," "tibiotalocalcaneal fusion," "TTC fusion," or "tibiofibular fusion" from 1987 to 2023. Data regarding patient demographics, causes cited for litigation, case outcomes, and indemnity settlements were collected. Cases were excluded if the defendant was not an orthopedic surgeon or a podiatrist, the procedure involved was not a hindfoot arthrodesis, or if the patient was a minor. Forty-five cases of hindfoot arthrodesis met the inclusion criteria. The mean plaintiff age was 51.5 ± 13.8 years with 51.1% male. Thirty-three cases (73%) were in favor of the defendant, with an average inflation-adjusted payout of $853,863 (±456,179). The most alleged category of negligence was procedural/intraoperative error (75%) followed by postsurgical error (38%) and failure to inform (31%). The most common specific damages included functional/ROM limitation (49%), need for additional surgery (47%), continuing/worsened pain (27%), and nonunion/malunion (29%). Given the frequency of hindfoot arthrodesis performed, this study highlights the importance of effective communication with patients concerning potential postoperative complications, prognosis of their injury, and risks and benefits associated with each treatment modality. [ABSTRACT FROM AUTHOR]

Many physicians, particularly neurosurgeons, face malpractice claims during their career. The aim of this paper is to identify which factors increase the risk of litigation and influence legal outcomes relating to cerebrospinal fluid shunt management. Westlaw, an online legal database, was used to identify all medico-legal cases pertaining to cerebrospinal fluid shunts. Information regarding plaintiff demographics, defendant specialties, reasons for litigation, and trial outcomes were analysed. Thirty-six cases met criteria for inclusion. Most cases returned a defence verdict (44.4%), with delayed treatment or failure to appropriately treat patients with shunts the most common reason for litigation (66.7%). The average plaintiff verdict payout was $4,888,136.75 and average settlement $1,362,307.69. Delay or failure to treat resulted in the largest average payouts for plaintiff verdicts and settlements ($5,329,299.14 and $1,531,500.00, respectively). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: AETCOM module 4.9 aims to sensitize students to legal aspects of care including negligence. It is a major public health issue related to patient safety. Aims & Objectives: This study was done to assess the effectiveness of the hybrid problem-oriented approach in teaching this module among phase 3 part-2 MBBS students and its perception among students and faculty. Methodology: Module-based educational prospective interventional study involving final MBBS students and faculty of Pediatrics Department. AETCOM Module was implemented as per NMC (National Medical Commission), India suggestions involving 1 hour of sensitization, 3 hours of self-directed learning 1 hour of role play and interactive lecture, and 1 hour of panel discussion. Pre- and post-test scores of pre-validated MCQs to assess knowledge, case closure, reflections and Likert's scale for perception were recorded. Results: 115 final MBBS students and 6 faculty of the Department of Pediatrics participated. Significant improvement in post-test score of MCQ (mean 6.2 to 7.2 p<0.0001 on Wilcoxon signed rank test) and score on case closure (n=97, 84.3% scoring >80%) was observed. It was well received by students (n=112, 97.4%- satisfied or very satisfied) and faculty (n=5, 83.3%- very satisfied). They also found it useful (n=4, 66.7%). Majority of students strongly agreed that it enhanced understanding (n=88, 76.5%), it was practical (n=92, 80%), interesting (n=88, 76.5%), interactive (n=91, 79.1%) and promoted learning retention (n=78, 67.8%). Conclusion: A hybrid problem-based approach for teaching AETCOM module 4.9 was found to be effective in imparting knowledge and comprehension and it was well appreciated by students and faculty members. [ABSTRACT FROM AUTHOR]

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities. [ABSTRACT FROM AUTHOR]

Neurosurgery has 1 of the highest risks for medical malpractice claims. We reviewed the factors associated with neurosurgical malpractice claims and litigation in the United States and reported the outcomes through a systematic review of the literature. We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines using the Medline, Embase, Cochrane, PubMed, and Google Scholar databases. We sought to identify pertinent studies containing information about medical malpractice claims and outcomes involving neurosurgeons in the United States. We identified 15 retrospective studies spanning from 2002 to 2023 that reviewed over 7890 malpractice claims involving practicing neurosurgeons in the United States. Disparities were evident in neurosurgical litigation, with 474 cases linked to brain-related surgeries and a larger proportion, 1926 cases, tied to spine surgeries. The most commonly filed claims were intraprocedural errors (37.4%), delayed diagnoses (32.1%), and failure to treat (28.8%). Less frequently filed claims included misdiagnosis or choice of incorrect procedure (18.4%), occurrence of death (17.3%), test misinterpretation (14.4%), failure to appropriately refer patients for evaluation/treatment (14.3%), unnecessary surgical procedures (13.3%), and lack of informed consent (8.3%). The defendant was favored in 44.3% of claims, while in 31.3% of lawsuits were dropped, 17.7% of verdicts favored the plaintiff, and 16.6% reached an out of court settlement. Only 3.5% of lawsuits found both parties liable. Neurosurgery is a high-risk specialty with 1 of the highest rates of malpractice claims. Spine claims had a significantly higher rate of filed malpractice claims, while cranial malpractice claims were associated with higher litigation compensation. Predictably, spinal cord injuries play a crucial role in predicting litigation. Importantly, nonsurgical treatments are also a common source of liability in neurosurgical practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traditional Medical Complementary Therapies is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. In the hospital environment, any liability for organizational inadequacy and/or inefficiency, or again for defects in the facilities, or inadequacy of health equipment may be found in the work of the apex professional figures: Medical Director, the General Manager, and/or others. The responsibility for the internal organization of the department falls on the figure of the Director of the Complex Structure where the deficiencies have not been promptly and adequately reported to the top figures. Case Report. A woman 61-year-old, was admitted on a voluntary basis to the Department of Psychiatry. On the third day, in the early morning hours, the patient was found on the ground floor, lying on the floor near the entrance door of the ward with a lacerated contusion wound to the head. The woman underwent total body CT examination with findings of fractured polytrauma as well as subarachnoid hemorrhage and complete fracture of the spleen, which was surgically removed. Three days later, despite the care given, death occurred. The injuries ascertained were consistent with voluntary precipitation from the second-floor stairwell window. The investigations conducted by the police and the checks carried out by the head of the Internal Prevention and Protection Service and the company's Risk Manager, highlighted multiple critical issues. Conclusion. The case allows for numerous considerations relating to liability profiles in the determinism of the patient's death, the hospital's company failure to implement measures to prevent the patient's suicide in the hospital was influential. [ABSTRACT FROM AUTHOR]

Background. In recent years, due to the increase in medical malpractice complaints, the Sicilian Regional Health System has adopted procedures for the direct management of claims by each health facility with the aim of reducing the costs of insurance premiums and related taxes. Mandatory sentinel event monitoring is a crucial part of this strategy to improve patient safety and quality of care. The reported case relates to a laparoscopic myomectomy surgery performed by means of morcellation, a controversial technique. After the FDA's intervention in 2014, it is believed that morcellation may worsen the staging of the disease by spreading malignancies such as leiomyosarcoma into the abdomen. Case report. A 28-year-old woman, underwent laparoscopic surgery for uterine fibroids and an ovarian cyst removal in August 2018. Post-surgery, she was diagnosed with Leiomyoma. She returned to the hospital due to metrorrhagia and was discharged after a week. Persistent symptoms led to her readmission and subsequent exploratory laparoscopic surgery at another hospital. This resulted in a total hysterectomy and the discovery of uterine leiomyosarcoma, with FIGO STAGE IIIB staging. Despite chemotherapy, she passed away six months later. Discussion and Conclusions. This case highlights medical-legal issues. Informed consent for morcellation and its risks was not obtained. The morcellation technique was used, increasing cancer spread risk. The histopathological process was inadequate, with three biopsies leading to misdiagnosis. This could be medical malpractice, making providers legally responsible for the patient's deteriorating condition and the anticipation of possible death. [ABSTRACT FROM AUTHOR]

AbstractThe establishment of the National Practitioner Data Bank (NPDB) was authorized in the Health Care Quality Improvement Act of 1986, and it mandated a federal database to collect information related to adverse actions initially against just physicians and dentists throughout the United States, including payments from malpractice lawsuits, restrictions on clinical privileges by hospitals, and medical licensure limitations and revocations by state licensing boards. The aggregate data reports made by this federal data bank began in 1991. The reporting level for the first ten years remained relatively stable in the nationwide range of 16,000 to 18,000 reports per year, but then a steady decline occurred over the second and third decades to under 8,000 reports per year by the year 2021. The researchers in this study explored a theory that might explain at least part of the drop in the states’ reporting levels. That is, states that could be called “Plaintiff-Favorable” (Arizona, Kentucky, New York, Pennsylvania, and Washington) would demonstrate a lesser rate of decline or even an increase in the reporting levels, and states that could be characterized as “Defendant-Favorable” (California, Michigan, Nevada, North Carolina, and Texas) would demonstrate a comparatively greater rate of decline in the reporting levels. The decline in reporting to the NPDB proved fairly consistent for both Plaintiff-Favorable and Defendant-Favorable states. The larger question as to why there occurred an overall negative trend in reporting to the NPDB across the United States during the second and third decades remains an intriguing area for future exploration. [ABSTRACT FROM AUTHOR]

Background: High reliability in health care requires a balance between intentionally designed systems and individual professional accountability. One element of accountability includes a process for addressing clinicians whose practices are associated with a disproportionate share of patient complaints. This study aimed to evaluate the impact of the Patient Advocacy Reporting System (PARS), a tiered intervention model to reduce patient complaints about clinicians. Methods: A retrospective cohort study was conducted involving a southeastern U.S. orthopaedic group practice. The study assessed the implementation of the PARS program and subsequent malpractice claims from 2004 to 2020. Results: The implementation of PARS was associated with an 83% reduction in malpractice claims cost per high-risk clinician after intervention (p = 0.05; Wilcoxon rank sum test). The overall practice group experienced an 87% reduction in mean annual claims cost per clinician (p = 0.007; segmented regression). The successful adoption required essential elements such as PARS champions, peer messengers, an Office of Patient Affairs, and a clear statement of practice values and professionalism expectations at the time of onboarding. Conclusions: The PARS program was successfully adopted within a surgical specialty group as a part of ongoing risk prevention and management efforts. The period following PARS was associated with a retrospectively measured reduction in malpractice claim costs. The PARS program can be effectively implemented in a large, single-specialty orthopaedic practice setting and, although not necessarily causal, was, in our case, associated with a period of reduced malpractice claim costs. Clinical Relevance: We have learned in previous research that there are clear links between professionalism and patient outcomes (e.g., surgical complications), but agree that the focus here on medical malpractice is not directly clinical. [ABSTRACT FROM AUTHOR]

Medical negligence (MN) remains a significant issue within the healthcare (HC) system in India, where the medical profession is held in high esteem but is not immune to human error. This study examines the various legal frameworks--civil, criminal, and consumer law--that address MN, outlining the challenges of holding HC providers accountable due to the complex nature of medical practice. Legal provisions under the Indian Penal Code (IPC), Tort Law, and the Consumer Protection Act (CPA) provide avenues for patients to seek redressal, though each system operates under distinct legal principles. The study also offers recommendations to address the MN crisis, including the creation of a national database, uniform compensation measures, and an analysis of judicial decisions to enhance healthcare system transparency. Ultimately, the study advocates for stronger legal protections, comprehensive reforms, and a balanced approach to uphold both patient rights and medical professionalism in India. [ABSTRACT FROM AUTHOR]

Introduction: Plastic Surgery, since its origins, has had within its scope of competence, attention to reconstructive and aesthetic aspects; However, until August 2023, the latter did not have official academic recognition as a fundamental part of said specialty, which allowed the false impression of an apparent «academic void», which gave rise to various Master's courses in «Aesthetic Surgery». Objective: the objective of this review was to identify and analyze the practice of Aesthetic and Reconstructive Plastic Surgery, from the data of the General Directorate of Arbitration of the National Commission for Medical Arbitration (CONAMED), from 2012 to 2022. Particularly in cases identified with malpractice. Material and methods: the files of the Archive of the General Directorate of Arbitration of CONAMED were reviewed. An observational, descriptive, cross-sectional and retrospective study was carried out. Institutional Medical Opinions and Reports referring to the specialty of Plastic, Aesthetic and Reconstructive Surgery were included in the sample, selecting those specifically linked to Aesthetic Plastic Surgery in which malpractice was identified. Results: the total sample consisted of 46 files (100%), referring to the specialty of Aesthetic and Reconstructive Plastic Surgery, which were analyzed in the General Directorate of Arbitration of the National Medical Arbitration Commission with 33 Institutional Medical Opinions and 13 Reports. [ABSTRACT FROM AUTHOR]

To evaluate plaintiff and defendant characteristics associated with iatrogenic genitourinary (GU) trauma litigation and outcomes of closed claims. LexisNexis was queried in April 2023 using terms related to GU organs and injury, and manually reviewed for iatrogenic cases. Case details including defendant, organ involvement, and legal outcome were obtained. Multinomial regression analysis was performed to identify factors associated with outcome. Four hundred ten cases involving 611 defendants were identified, with the ureter the most commonly affected organ (202/410, 49.3%). Most cases involved adult plaintiffs (380, 92.7%) and resulted in favor of the defense (227, 55.4%). Injuries resulted most frequently from gynecologic surgeries (179, 43.7%). Defendants were most commonly obstetricians/gynecologists (243/611, 39.8%) and urologists (168, 27.5%). Penile (OR 6.3 [95% CI 2.5-16.1]) and urethral (OR 4.8 [2.0-11.7]) injuries were associated with greater odds of a plaintiff verdict relative to ureter injury. A plaintiff verdict was also more likely when defendants were academic hospitals compared to individual practitioners (OR 4.3 [1.9-9.9]). In cases ruling in favor of the plaintiff, indemnity payments were larger when the defendants were comprised of individual practitioners compared to a hospital or medical group (median $549,613 vs $250,000, P <.001). Urologists may be involved in medical malpractice lawsuits for iatrogenic injury even when they are uninvolved in the index procedure. Most cases that reach litigation result in defense verdicts regardless of the GU organ injured. Defendant characteristics associated with plaintiff verdicts are more nuanced, and providers should be aware of potential downstream effects of litigation. [ABSTRACT FROM AUTHOR]

Tort liability is designed to economically incentivize safer behavior by compelling the tortfeasor to pay money to a person injured by the tortfeasor's conduct. In medical malpractice cases, this safer conduct should, in turn, improve patient safety and reduce adverse events. Most medical errors are the result of faulty systems and processes that are outside the control of individual clinicians working within those systems. Yet, the historical approach of holding hospitals only vicariously liable focuses solely on the individual clinicians' actions and does not hold hospitals accountable for their failure to fix the defective system and processes. Hospitals have a nondelegable duty to develop, adopt, and enforce adequate and appropriate processes, procedures, rules, and policies to ensure the delivery of quality care to their patients. Would holding hospitals directly liable for system failures motivate them financially and reputationally to improve their systems, thereby having the greatest effect on reducing patient harm? [ABSTRACT FROM AUTHOR]

Background. Since 2012, the Sicilian regional government, in view of the increase in malpractice claims, has adopted a "self-insurance system" The claims management activities have been delegated to the Claims Management Committees (CMCs), the importance of which was also emphasized by Law No. 24/2017. This study aims to describe the experience of Sicilian Hospital CMC and analyze the claims' features, especially for contentious HAIs. Healthcare-associated infections (HAIs) continue to be a major public health concern. The contraction of infection during hospitalization generally results in a significant worsening of the patient's quality of life and prolongation of his or her stay. Still, it is also responsible for an increase in costs that burden the hospital and the entire Health System. Material and Methods. The study investigates the analysis of claims received by a Messina Hospital Company between January 2015 and December 2023 even though for events that occurred in earlier years. From the database, cases in which the Company was sued for HAIs were extrapolated and analyzed, distinguishing them by year and by Department. The data collected were statistically processed with the Epi Info 7.1.5 program (CDC - Atlanta - USA). Conclusion. The CMC experience highlighted a statistically significant increase in complaints especially for those relating to HAI, without differences by Department. In most cases, the CMC admitted the hospital's liability, and an attempt at conciliation was promoted and moreover risk management initiatives were adopted. This is important when considering the recent ruling 6386/2023 of March 3, 2023. [ABSTRACT FROM AUTHOR]

Copyright of General Medicine & Health Sciences / Medycyna Ogólna i Nauki o Zdrowiu is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Mistrust of doctors and the desire for compensation are driving a rise in malpractice litigation worldwide. Aim. To estimate the extent to which Italians view birth complications as malpractice in obstetric care, and how widespread this perception is. Method. WhatsApp® and Facebook® contacts of one of the authors were invited to respond to an online questionnaire. The answers of 265 Italian respondents were used to estimate how common the perception of obstetric staff errors is and how this perception spreads over time: the denigration curve. To test if the denigration curve is reliable, the curve has been plotted along with the trend of the rate of litigation in Italy. Results. Almost a 50% of respondents deemed that birth complications are due to obstetric staff errors. The likelihood of the perception that one has experienced a birth complication was 64.5%. The communication of obstetric staff error seemed low overall among the respondents. The denigration curve shape is almost coincident with the curve of claim rates in Italy, proving that it would be reliable. Conclusion. The respondents provided an estimate of the rate of birth complications that was higher than the real occurrence rate, and attributed these complications to obstetric staff errors. The denigration curve could predict whether and when there might be litigation related to any birth complications (both error related and non-error related). [ABSTRACT FROM AUTHOR]

Obstetric violence is currently not acknowledged as a form of gender-based violence in South African law. In this article I deal with the various issues associated with this failure to correctly categorise obstetric violence. One of the issues relates to access to legal recourse for survivors through delictual claims (torts). Delictual claims are wrongful acts or limitations of rights that can lead to legal liability in the form of monetary compensation. The current framing of obstetric violence as medical malpractice limits women's time to launch a case to only three years after the violation. To show how this issue of prescription (a legal principle where an outstanding debt can be extinguished after a prescribed time period) plays out, I focus on the 2020 report by the South African Commission for Gender Equality (CGE) on the forced or coerced sterilisation of women living with HIV at state healthcare facilities. I also examine the current case of the Centre for Applied Legal Studies (CALS), a university-based human rights law clinic, which represents over 40 women who have experienced different forms of obstetric violence at state-run facilities. In both of these examples, I explain how justice through legal recourse is denied to these victims or survivors through the mischaracterisation of obstetric violence as medical malpractice in current South African law. To show that the three-year 'limit' or prescription period to institute a legal claim is unjustifiable, I explore three reasons why women may not choose to or be able to proceed with a legal claim within that time period. The first of these relates to the 'personal' barrier women face around acknowledging they have experienced obstetric violence and bringing a claim against the state. The second, the 'political' barrier, includes the general and prevalent systemic gender discrimination experienced by women in South Africa and the specific barriers women face around access to dignified treatment in the country's public healthcare system. Finally, an 'economic' barrier is the general inaccessibility of legal representation for economically disadvantaged people in the country. Proceeding from the above, I then argue that by acknowledging obstetric violence as a form of gender-based violence and aligning it with legislation around prescription periods for other forms of gender-based violence (such as sexual offences), the burdens related to access to justice (at least in delict) can be lightened for survivors. [ABSTRACT FROM AUTHOR]

Financial sustainability is a recurring challenge for public organizations and is closely linked to resource allocation. Medical malpractice claims can significantly impact public healthcare costs, prompting several countries, including Italy, to adopt different strategies for managing these risks. These strategies range from insurance-based systems to self-insurance models. While the former offers greater long-term security, it tends to be more expensive in the short term. Conversely, self-insurance, if properly implemented, can provide both adequate protection and cost savings. However, it also carries the risk of incentivizing opportunistic behavior aimed at achieving short-term financial gains. This study explores the propensity of Italian healthcare organizations to choose between these approaches and the relationship between their choice and short-term financial viability. A quantitative analysis of the relationship between premiums, provisions, and financial indicators, such as ROA and ROS provides empirical evidence of potential opportunistic behavior. Additionally, semi-structured interviews are conducted to validate the interpretations from the statistical analyses. Our findings reveal that many regional administrations have insufficient coverage for risk exposure, which may temporarily improve financial performance but increase the risk of long-term financial instability.

Introduction: In recent years, the field of medical malpractice has attracted growing attention, and despite the long history of research in this area, aspects of this phenomenon remain unexplored. In this paper, we aimed to explore the issue of medical malpractice, focusing on cases involving healthcare professionals working in emergency services in Türkiye. We examine the surge in medical malpractice lawsuits, the consequences of such cases, and the prevalence of criminal liability faced by healthcare professionals. Materials and methods: A comprehensive analysis of healthcare-related cases from 2017 to 2022 was carried out using the electronic decision database “LEGALBANK.” We scrutinized these cases from both medical and criminal law perspectives, aiming to shed light on the complex dynamics of medical malpractice in emergency services. Results: The findings reveal that professionals in emergency services are confronted with a considerable number of criminal cases. Among these cases, doctors are the most frequently implicated, followed by nurses, midwives, ambulance drivers, and other healthcare professionals. The crimes attributed to these professionals vary but primarily include involuntary manslaughter, misuse of public duty, forgery of documents, and reckless injury. Discussion: In Türkiye, there is a notable prevalence of investigations conducted in emergency services and criminal cases involving healthcare professionals in this field. This dual prominence underscores the unique significance of examining medical malpractice from the perspectives of both criminal law and medicine within the Turkish context. This study categorizes the multifaceted challenges of medical malpractice as human-related, system-related, and legal, offering valuable insights into the intricate landscape of this phenomenon in Türkiye's emergency services. Conclusion: This research contributes to a deeper understanding of medical malpractice, particularly its criminal dimensions in the Turkish context, and thereby calls for improved healthcare, enhanced patient safety, and error prevention in emergency settings.

Abstract Cosmetic filler injections have gained popularity in recent years, but the rise in complications has led to an increase in legal disputes. This study analyzes civil court rulings related to cosmetic filler injection lawsuits in South Korea from 2007 to 2023. A retrospective case analysis was performed using a systematic database search, and a mixed-methods approach was employed for data analysis. The study examined 27 cases, revealing a high rate of liability findings against medical practitioners. Skin necrosis and blindness were the most common complications, and intravascular filler injection was recognized as negligence. Violation of informed consent was found in most cases, with mean compensation awards of ￦193,019,107 KRW ($142,831 USD) for first instance cases and ￦81,845,052 KRW ($60,564 USD) for second instance cases. The findings emphasize the importance of practitioner awareness, adherence to precautionary measures, and proactive prevention and management of complications. Collaboration among stakeholders is crucial for developing strategies that prioritize patient safety and minimize legal disputes in the aesthetic medicine industry. This study provides valuable insights for enhancing medical practices and safeguarding patient well-being in the field of cosmetic filler injections.

Burns 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. The 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. A 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. Never 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. ● Burn injuries contribute significantly to the medical malpractice landscape. ● Never events causing burns in plastic surgery are caused by human error or neglect. ● Overheated instruments and cauterizers were the leading mechanisms for litigation. ● Additional safeguards should be added to minimize litigation and harm to patients. [ABSTRACT FROM AUTHOR]

General surgery is a highly litigious specialty. Lawsuits can be a source of emotional distress and burnout for surgeons. Major hepatic and pancreatic surgeries are technically challenging general surgical oncology procedures associated with an increased risk of complications and mortality. It is unclear whether these operations are associated with an increased risk of lawsuits. The objective of the present study was to summarize the medical malpractice claims surrounding pancreatic and hepatic surgeries from publicly available court records. The Westlaw legal database was searched and analyzed for relevant malpractice claims from the last two decades. Of 165 search results, 30 (18.2%) cases were eligible for inclusion. Appellant cases comprised 53.3% of them. Half involved a patient death. Including co-defendants, a majority (n = 21, 70%) named surgeons as defendants, whereas several claims (n = 13, 43%) also named non-surgeons. The most common cause of alleged malpractice was a delay in diagnosis (n = 12, 40%). In eight of these, surgery could not be performed. The second most common were claims alleging the follow-up surgery was due to negligence (n = 6). Collectively, 20 claims were found in favor of the defendant. Seven verdicts (23.3%) returned in favor of the plaintiff, two of which resulted in monetary awards (totaling $1,608,325 and $424,933.85). Three cases went to trial or delayed motion for summary judgment. There were no settlements. A defendant verdict was reached in two-thirds of malpractice cases involving major hepatic or pancreatic surgery. A delay in diagnosis was the most cited claim in hepatopancreaticobiliary lawsuits, and defendants may often practice in nonsurgical specialties. While rulings favoring plaintiffs are less frequent, the payouts may be substantial. [ABSTRACT FROM AUTHOR]

BACKGROUND Physician malpractice lawsuits are climbing, and the reasons underlying litigation against dermatologists are unclear. OBJECTIVE To determine the reasons patients pursue litigation against dermatologists or dermatology practices. MATERIALS AND METHODS A retrospective analysis of all state and federal cases between 2011 and 2022 was performed after a query using "Dermatology" and "dermatologist" as search terms on 2 national legal data repositories. RESULTS The authors identified a total of 48 (37 state and 11 federal) lawsuits in which a practicing dermatologist or dermatology group practice was the defendant. The most common reason for litigation was unexpected harm (26 cases, 54.2%), followed by diagnostic error (e.g. incorrect or delayed diagnoses) (16 cases, 33.3%). Six cases resulted from the dermatologist failing to communicate important information, such as medication side effects or obtaining informed consent. Male dermatologists were sued at a rate 3.1 times higher than female dermatologists. CONCLUSION Although lawsuits from patients against dermatologists largely involve injury from elective procedures, clinicians should practice caution regarding missed diagnoses and ensure critical information is shared with patients to safeguard against easily avoidable litigation. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Current responses to medical negligence insufficiently consider the broader needs of affected stakeholders. We argue that responses to medical negligence should adopt a restorative justice frame. This article recounts the experience of our daughter's avoidable suffering and subsequent death in the healthcare system. Our experience as victims of medical negligence, and the broader literature on restorative justice, responsive regulation and health care, suggest that non-adversarial alternatives will better address the needs of victims and encourage a restoration in healthcare relationships. [ABSTRACT FROM AUTHOR]

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)