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Introduction: Despite significant advances in surgical techniques and patient outcomes, organ transplantation (OT) remains fraught with legal challenges and ethical dilemmas. This study aims to address the notable gap in literature on malpractice claims specifically related to OT, providing insights into litigation trends, outcomes, and implications for medical practice and patient care. Methods: We retrospectively queried the Verdictsearch database from 1988 to 2023, and captured malpractice claims involving several organs. Data on demographics, organ types, and litigation outcomes were collected to compare compensation across different categories of malpractice and patient outcomes. Results: Out of 292 malpractice cases identified, 62 met inclusion criteria, distributed across 19 states with kidney being the most implicated organ (46.8%). Defendants prevailed in 53.2% of cases, while settlements were reached in 29.0%, and plaintiffs won in 16.1% of cases. Surgical errors and complications were the most frequent allegations, followed by medication and treatment errors. The median compensation for deceased plaintiffs was significantly higher ($1,300,000) compared to living plaintiffs at litigation initiation ($128,000). Discussion: Our study sheds light on the challenges and trends in malpractice litigation within the field of OT. By identifying key areas of concern and the influence of patient outcomes on litigation resolution, this study offers valuable insights for healthcare providers, legal practitioners, and policymakers aimed at enhancing patient safety, reducing litigation risks, and fostering a deeper understanding of the ethical and legal complexities in OT. [ABSTRACT FROM AUTHOR]

IntroductionDespite significant advances in surgical techniques and patient outcomes, organ transplantation (OT) remains fraught with legal challenges and ethical dilemmas. This study aims to address the notable gap in literature on malpractice claims specifically related to OT, providing insights into litigation trends, outcomes, and implications for medical practice and patient care.MethodsWe retrospectively queried the Verdictsearch database from 1988 to 2023, and captured malpractice claims involving several organs. Data on demographics, organ types, and litigation outcomes were collected to compare compensation across different categories of malpractice and patient outcomes.ResultsOut of 292 malpractice cases identified, 62 met inclusion criteria, distributed across 19 states with kidney being the most implicated organ (46.8%). Defendants prevailed in 53.2% of cases, while settlements were reached in 29.0%, and plaintiffs won in 16.1% of cases. Surgical errors and complications were the most frequent allegations, followed by medication and treatment errors. The median compensation for deceased plaintiffs was significantly higher ($1,300,000) compared to living plaintiffs at litigation initiation ($128,000).DiscussionOur study sheds light on the challenges and trends in malpractice litigation within the field of OT. By identifying key areas of concern and the influence of patient outcomes on litigation resolution, this study offers valuable insights for healthcare providers, legal practitioners, and policymakers aimed at enhancing patient safety, reducing litigation risks, and fostering a deeper understanding of the ethical and legal complexities in OT.

Objective: To review the nature and extent of bladder exstrophy-epispadias related malpractice litigation in the United States. Methods: Two legal databases (Nexis Uni, WestLaw) were reviewed for state and federal cases using the terms "bladder exstrophy", "cloacal exstrophy", "epispadias", in combination with "medical malpractice", or "negligence", or "medical error", or "complication", or "malpractice", or "tort". Databases were queried from 1948 to 2022 and reviewed for medical and legal details. Results: Our search yielded 16 unique legal cases with 6 fitting established criteria for analysis. Urology and paediatric urologists were named in 50% of cases as were community medical systems. Cause for lawsuit included negligence in surgical performance (50%), primary closure of exstrophy (33%), and post-operative care (50%). Settlement agreement was reached in one case (17%). Outcomes favoured the physician in 60% of trials. Lawsuits alleging negligent surgical performance and/or post-operative care exclusively named urologists with outcomes favouring the surgeon in 66% of cases. The settlement payment (n = 1) was $500,000 and monetary damages (n = 1) equated to $1.3 million. Conclusions: Malpractice litigation related to BEEC treatment is rare. Trial outcomes favour the medical provider. Cases that resulted in financial liability successfully alleged avoidable negligence resulting in irreversible physical damage. The authors recommend families with BEEC seek board-certified paediatric urologists experienced in treating this complex and/or Bladder Exstrophy Centers of Excellence. Further, we recommend surgeons treating BEEC properly educate patients and families on the severity of this major birth defect including its lifelong implications and need for surgical revisions. [ABSTRACT FROM AUTHOR]

A new type of research has emerged with United States and European Union pediatric laws that request/demand separate clinical studies for vaccines and drugs in minors less than 18 years of age. Physiologically, minors mature before their 18th birthday. Medicine treats the body, not the administrative status. Many "pediatric" studies are performed in minors that bodily are no longer children, which makes them pointless. Traditional malpractice litigation in clinical research involves patients that were harmed in clinical studies. In the new type of "pediatric" studies, drugs known to work in humans are retested, pretending that "children" are uniquely different, which is incorrect. Minors are not another species. Patients are not treated at all (placebo group) or below standard-of-care (comparison to outdated treatment). Pediatric laws are the law, but not a free pass for harming patients. Where "pediatric" studies violate accepted norms of medical practice, lawyers should be aware of this challenge at the interface of medicine and law. [ABSTRACT FROM AUTHOR]

A medical malpractice lawsuit may be brought against health care providers, if there was a possibility of a negligence, or failure to meet the standard of care. Recently, clinical practice guidelines have increasingly been used as evidence of the standard of care. Nevertheless, it is not clear whether these guidelines can be used as evidence of the standard of care. We carried out a snapshot study to know whether or not there were dissociations between the current standard of anesthesia care and recommendations made by clinical practice guidelines. We asked all the 80 heads of Anesthesiology departments of Japanese public and private Universities, to answer questions related to difficult airway management after induction of anesthesia, postoperative monitoring of breathing, and of the presence or the absence of neuropathy of the lower legs after regional anesthesia. The response rate was 71% (57/80). The majority of anesthesiologists had little experience with front-of-neck access in patient, and responders might frequently make repeated attempts at tracheal intubation. Postoperative monitoring was frequently not routinely performed. In conclusion, this study has shown that there may be various degrees of dissociations between the current standard of anesthesia care and the recommendations made by clinical practice guidelines that had been used as evidence of the standard of care in medical malpractice lawsuit cases in Japan. [ABSTRACT FROM AUTHOR]

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Medication errors represent one of the most common causes of adverse events in pediatrics and are widely reported in the literature. Despite the awareness that children are at increased risk for medication errors, little is known about the real incidence of the phenomenon. Most studies have focused on prescription, although medication errors also include transcription, dispensing, dosage, administration, and certification errors. Known risk factors for therapeutic errors include parenteral infusions, oral fluid administration, and tablet splitting, as well as the off-label use of drugs with dosages taken from adult literature. Emergency Departments and Intensive Care Units constitute the care areas mainly affected by the phenomenon in the hospital setting. The present paper aims to identify the risk profiles in pediatric therapy to outline adequate preventive strategies. Precisely, through the analysis of the available evidence, solutions such as standardization of recommended doses for children, electronic prescribing, targeted training of healthcare professionals, and implementation of reporting systems will be indicated for the prevention of medication errors.

Objective: To analyse malpractice litigation cases in Japan and identify the factors related to choking accidents in older people. Background: Choking while eating is common in older people and has potentially severe consequences. Methods: This study analysed court decisions related to choking accidents occurring in Japan between 2000 and 2015 that involved the death of an older person or permanent severe choking‐related injury. A database of court decisions (n = 23) was constructed according to patient and caregiver characteristics, and nursing services. An analysis was performed on caregiver liability, and to identify factors related to choking accidents. Results: The court ruled that the caregiver was liable in 10 of the 23 cases. Liability was related to appropriate food choices, failure to monitor of eating or the non‐performance of resuscitation after an accident. Prior knowledge of aspiration (P <.001), inappropriate assistance during the meal (P <.001), and inappropriate emergency treatment (P =.028) were more likely to be present in cases in which caregivers were judged liable than in those in which they were not. Conclusions: Lack of appropriate assistance during the meal was the factor most strongly associated with a court ruling of caregiver liability for choking accidents in older people. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore state-level relationships between the incidence and payout amounts for medical malpractice claims and Medicare imaging utilization and spending across the United States.Methods: Using claims data from a 5% sample of Medicare beneficiaries for 2004 to 2016, annual state population-adjusted rates of imaging utilization and spending were calculated. Using National Practitioner Data Bank files, all paid physician malpractice claims were identified, and lagged state population-adjusted rolling averages of paid claim frequencies and payout amounts were calculated. Controlling for secular trends and state fixed effects with robust standard errors clustered at the state level to account for serial autocorrelation, associations between imaging utilization and lagged paid malpractice claims were assessed using multivariate regression models. Log-log model specification was used to obtain elasticity measures.Results: Between 2004 and 2016, national Medicare diagnostic imaging utilization and spending declined by 31.4% and 47.2%, respectively (from 355,057 to 243,517 examinations and from $28,591,146 to $15,099,291 per 100,000 beneficiaries). Overall national paid malpractice claims and payout amounts declined by 46.4% and 39.6%, respectively (from 4.83 to 2.59 claims and from $1,803,565 to $1,089,112 per 100,000 population). After controlling for secular trends and state fixed effects, advanced imaging utilization was positively associated with the lagged number of per capita paid malpractice claims. Each 1% increase in average paid malpractice claims was associated with a subsequent 0.20% increase in advanced imaging utilization (P = .001).Conclusions: Positive associations between paid malpractice claims and advanced Medicare imaging utilization support the contention that US physicians use medical imaging as a defensive medicine strategy. [ABSTRACT FROM AUTHOR]

Background: The judicialization of medicine can lead to professional disenchantment and defensive attitudes among surgeons. Some quantitative studies have investigated this topic in spine surgery, but none has provided direct thematic feedback from physicians. This qualitative study aimed to identify the impact of this phenomenon in the practice of spine neurosurgeons. Methods: We proposed a qualitative study using grounded theory approach. Twenty-three purposively selected private neurosurgeons participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and analyzed thematically and independently by three researchers (an anthropologist, a psychiatrist, and a neurosurgeon). Results: Data analysis identified five superordinate themes that were based on items that recurred in interviews: (1) private practice of spinal surgery (high-risk surgery based on frequent functional symptoms, in an unfavorable medicolegal context); (2) societal transformation of the doctor-patient relationship (new societal demands, impact of the internet and social network); (3) judicialization of spine surgery (surgeons' feelings about the frequency and motivation of the complaints they receive, and their own management of them); (4) coping strategies (identification and solutions for "at risk" situations and patients); and (5) professional disenchantment (impact of these events on surgeons' daily practice and career planning). Selected quotes of interviews were reported to support these findings. Conclusions: Our study highlights several elements that can alter the quality of care in a context of societal change and the judicialization of medicine. The alteration of the doctor-patient relationship and the permanent pressure of a possible complaint encourage surgeons to adopt defensive attitudes in order to minimize the risks of litigation and increased insurance premiums. These phenomena can affect the quality of care and the privacy of physicians to the extent that they may consider changing or interrupting their careers earlier. [ABSTRACT FROM AUTHOR]

Background: Prostate-Specific Antigen (PSA) screening for early detection of prostate cancer (PCa) may prevent some cancer deaths, but also may miss some cancers or lead to unnecessary and potentially harmful treatment. Therefore, involving patients in decision-making about PSA screening is recommended. However, we know little about the attitude of men regarding participation in decisions about PSA screening and how to assess such attitudes. The purpose of this paper is to describe patient and public participation in the development of a national, web-based case vignette survey for studying men's view on participation in decision-making about PSA screening.Methods: The project group developed a first draft plan for the survey, its vignettes and choice of measurements. This included multiple vignette variants representing various levels of patient participation in decision-making about PSA screening with different outcomes. Additionally, it included questions on respondents' satisfaction with imagined courses of health care, their propensity to initiate a malpractice complaint, their own health care experiences, socio-demography, personality, and preferences for control regarding health care decision-making. Following feedback from a workshop with academic peers on the draft plan, a group of 30 adult men was engaged to help develop case vignette versions and questionnaire items by providing feedback on structure, comprehension, response patterns, and time required to complete the survey. Furthermore, a panel of three patients with PCa experience was assembled to assist development through a separate review-and-feedback process.Results: Based on reviews of survey drafts, the large group made further suggestions about construction of the survey (e.g. clarification and modification of case vignette versions, deletion of items and adjustment of wording, instructions to guide respondents, replacement of technical terms, and optimization of sequence of survey elements). The patient panel ensured fine-tuning of vignette versions and questionnaire items and helped review the internet version of the survey.Conclusions: Patient and public involvement during various phases of the survey development helped modify and refine survey structure and content. The survey exemplifies a way to measure health care users' satisfaction with imagined courses of health care and wish to complain, taking into account their characteristics. [ABSTRACT FROM AUTHOR]

We model the interactions between the behaviors of physicians and patients, subject to clinical and legal risks, by means of evolutionary game theory. We propose an original game in which patients may sue their physician for medical malpractice, and physicians have to choose between two alternative treatments, with different levels of benefits and risks. The safer treatment is also the less effective, therefore its provision corresponds, under the assumptions of our model, to practicing negative defensive medicine. We study the Nash equilibria, test their stability in the replicator dynamics, and analyze their welfare properties. We find that the accuracy of the judicial system plays an important role, with possible counter-intuitive effects related to legal reforms. If the court is not sufficiently accurate, defensive medicine can be favored, paradoxically, by an increase in the probability that defensive physicians are sanctioned by the court. A similar outcome can be generated also by an increase in the compensation paid to patients by physicians, when sanctioned for medical malpractice. [ABSTRACT FROM AUTHOR]

Background: Propofol is has been widely used for sedation in the field of esthetic surgery because of its favorable pharmacokinetic profile. Propofol sedation-induced side effects are rare. However, when present, they can be serious. The number of malpractice claims associated with propofol sedation has increased in recent years. This study aims to show which procedures lead to the most claims in the field of esthetic surgery through a review of Korean precedents.Methods: Thirteen precedent cases of propofol sedation in the field of esthetic surgery were collected between 2000 and 2016. We analyzed the type of procedure, administration route, anesthesia provider, complications, timing of damaging events, average indemnification, plaintiff’s (patients) winning rate, ratio and the reason of limitation of liability and the key factors affecting the judgement in these cases.Results: Most plaintiffs were women, and in most cases (11/13, 73.3%), the times of the damaging events were in maintenance and the anesthesia provider was the surgeon. The most common complication related to propofol sedation was hypoxic brain damage. Among the 13 cases, 12 were won by the plaintiff. The mean claim settlement was 339,455,814 KRW (USD 301,792.15). The key factors affecting the judgement were administration method and staff, monitoring method, preparation of emergency kit, response to emergencies, transfer to a higher-level hospital, detailed medical recording about event and informed consent.Conclusion: The number of claims owing to propofol sedation after esthetic surgery is increasing. Close monitoring during the operation, immediate reaction to an event and thorough medical records were main key factors that influenced the judgement. Preoperative explanation about the possibility of complications was important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns.Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Objective: Expert witness testimony is crucial for juror decision making. The goals of this study were to examine the trends in malpractice litigation in plastic surgery and to examine the characteristics of expert witnesses in litigation. Methods: The Westlaw legal database was queried for jury verdict and settlement reports related to plastic surgery cases from 2009 to 2015. Cases were examined for expert witness testimony, procedure performed, alleged injury, cause of action, verdict, and indemnity payments. Results: Ninety-three relevant cases were examined. Mean plaintiff award was $1,036,469, whereas mean settlement was $633,960. The most commonly litigated procedures involved breast surgery (34.4%), liposuction (18.3%), and body contouring (14.0%). Cases involving body contouring (risk ratio [RR] = 1.48; 95% CI, 1.04-2.10) were more likely to result in favor of the defendant, whereas cases involving breast surgery (RR = 0.27; 95% CI, 0.13-0.57) were more likely to result in favor of the plaintiff (P < .05). Cases in which there was claimed pain (RR = 1.22; 95% CI, 1.01-1.48) or emotional distress (RR = 1.38; 95% CI, 1.11-1.70) were more likely to result in favor of the plaintiff (P < .05). The party of a lawsuit was more likely to win the case if its expert witness was a plastic surgeon (P < .05). Conclusion: Plastic surgery litigation tends to favor defendants. Most litigation involves breast surgery, liposuction, and body contouring. The type of procedure and alleged claim affect case success. Parties with a plastic surgeon as an expert witness tend to be more successful in litigation. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: The aim of this study was to evaluate factors raised in malpractice litigation related to the diagnosis and management of melanoma and to further assess issues impacting outcome.Study Design: Retrospective chart review.Methods: The Westlaw legal database was searched for malpractice litigation resolved over the last 20 years relating to melanoma. Cases were evaluated for allegations, defendant specialty, outcome, and other issues raised.Results: Of the 80 cases evaluated, 49% were resolved in the defendants' favor. In greater than 80% of cases, there was alleged misdiagnosis. In 35% of cases, the patient had expired secondary to melanoma at the time of litigation. There was no statistical difference in payments upon comparison of cases with and without mortality. A greater proportion of cases with dermatologists and pathologists as defendants involved alleged misdiagnosis. The most common locations for melanoma were the extremities and the head-and-neck region, at 32.5% and 22.5%, respectively. Location did not significantly impact the outcome of cases.Conclusion: Malpractice litigation relating to melanoma involves numerous physicians, including dermatologists, pathologists, and otolaryngologists. Alleged misdiagnosis of a pigmented lesion was the most common cause of litigation and involved physicians from numerous specialties. Patients who were misdiagnosed had a significantly higher likelihood of having active disease at the time of litigation. Ultimately improved methods of detecting concerning pigmented lesions need to be developed. Factors such as death and poor cosmetic outcome did not significantly impact litigation outcome.Level Of Evidence: NA Laryngoscope, 127:134-139, 2017. [ABSTRACT FROM AUTHOR]

The purpose of this study was to find causes, outcomes, and trends in malpractice litigation involving blood transfusions in China. This study examines 108 claims resulting from transfusion-related complications over a period of 15 years. The primary outcomes associated with these claims included transfusion-transmitted infection (98 cases, 90.8%), transfusion reactions (nine cases, 8.3%), and failures to obtain informed consent (one case, 0.9%). The specialty of obstetrics and gynecology was more likely to be accepted in judgment. As the supreme status of law, Blood Donation Law plays an important role in the blood safety, which results in less HCV infection cases occurred after 1998. Though the 2002 and 2010's rules give opposite liability principle, the fault liability and no-fault liability, the statistics shows that rules do not have an effect on different liabilities in judicial practice. The current study concludes that the risk of serious adverse transfusion reactions may be significantly increased by unnecessary transfusions. [ABSTRACT FROM AUTHOR]

Expert witnesses play an invaluable, if controversial, role by deciphering medical events for juries in cases of alleged negligence. We review expert witness guidelines among major surgical societies and identify gaps within these standards, as our hope is that this spurs discussion addressing areas for improvement. Of 8 surgical societies with accessible guidelines, none included specific compensation guidelines or limits, detailed reporting mechanisms regarding unethical behavior by legal professionals, or addressed the appropriateness of testifying frequently and exclusively for one side. Several processes possibly deterring grossly inaccurate testimony have been adopted by other surgical societies and should potentially be addressed by the American Academy of Otolaryngology—Head and Neck Surgery. These include offering an expert witness testimony certification path, strengthening the formalized grievance process, and encouraging members to sign an affirmation statement. [ABSTRACT FROM PUBLISHER]

Introduction Erectile dysfunction ( ED) is a common problem with significant impact on patient quality of life. Penile prosthesis implantation provides an effective treatment for ED but as an invasive procedure carries with it an increased risk of medicolegal liability. Aim To investigate factors associated with malpractice litigation surrounding penile prosthesis implantation. Methods The Westlaw legal database was used to perform an advanced search for case reports using the term 'medical malpractice' in combination with 'penile' or 'penis' and 'prosthesis' or 'implant' with dates between the January 1990 and December 2013. Main Outcome Measures Each report was examined for trial information including patient demographics, device model and indications, alleged breach of duty, alleged damages, progression to trial, case outcome, and plaintiff award(s). Results The initial search yielded 76 cases that were narrowed to 40 after exclusions. There were 23 (57.5%) cases that were found in favor of the defendant, while 17 (42.5%) cases led to indemnity payment to the plaintiff including two cases (5.0%) that were settled out of court and 15 (37.5%) favoring the plaintiff in front of a jury. The mean settlement received was $335,500 compared with the mean indemnity award of $831,050 for verdicts decided in favor of the plaintiff ( P = 0.68). The most common breach of duty was error in surgical decision making, present in 20 cases (48.8%). Informed consent was an issue in 13 filings (31.7%), and postoperative infection was seen in 13 cases (31.7%). In cases that identified the type of implant used, 58.3% were malleable implants, and 41.7% were inflatable devices. Conclusions The main issues involved in malpractice litigation for penile prosthesis implants included surgical performance, informed consent, and postoperative management. Urologists must be aware of these potential issues in order to minimize their malpractice liability. Sunaryo PL, Colaco M, and Terlecki R. Penile prostheses and the litigious patient: A legal database review. J Sex Med 2014;11:2589-2594. [ABSTRACT FROM AUTHOR]

Objective To assess the potential deterrent effect of nursing home litigation threat on nursing home quality. Data Sources/Study Setting We use a panel dataset of litigation claims and Nursing Home Online Survey Certification and Reporting ( OSCAR) data from 1995 to 2005 in six states: Florida, Illinois, Wisconsin, New Jersey, Missouri, and Delaware, for a total of 2,245 facilities. Claims data are from Westlaw's Adverse Filings database, a proprietary legal database, on all malpractice, negligence, and personal injury/wrongful death claims filed against nursing facilities. Study Design A lagged 2-year moving average of the county-level number of malpractice claims is used to represent the threat of litigation. We use facility fixed-effects models to examine the relationship between the threat of litigation and nursing home quality. Principal Findings We find significant increases in registered nurse-to-total staffing ratios in response to rising malpractice threat, and a reduction in pressure sores among highly staffed facilities. However, the magnitude of the deterrence effect is small. Conclusions Deterrence in response to the threat of malpractice litigation is unlikely to lead to widespread improvements in nursing home quality. This should be weighed against other benefits and costs of litigation to assess the net benefit of tort reform. [ABSTRACT FROM AUTHOR]

Abstract: Malpractice litigation involving the delivery of breast care has been evaluated in the United States of America (USA) but is a relatively new area of study in the United Kingdom (UK). We sought to study and evaluate the emerging trends in litigation claims in relation to breast disease with the National Health Service Litigation Authority (NHSLA) over the last 15 years, up to December 2010. [Copyright &y& Elsevier]

Abstract: Claims for poor cosmetic outcome account for a large proportion of breast care malpractice litigation in the UK. Detailed analysis of such claims has not been conducted. We sought to analyse National Health Service Litigation Authority (NHSLA) data pertaining to breast care over the period September 2005–April 2008, focussing on claims for poor cosmetic outcome. Data from a medical indemnity organisation detailing similar claims in the private sector were also analysed. Comparison of the NHSLA data with previously obtained NHSLA data (May 1995–September 2005) demonstrated an upward trend in claims for poor cosmetic outcome. The majority of claimants for poor cosmesis had benign disease and the vast majority of claimants with breast malignancy had undergone breast reconstruction. The majority of claims for poor cosmetic outcome were against plastic surgeons. This was more marked in the private sector data than in the NHSLA data, reflecting their workload. [Copyright &y& Elsevier]

Abstract: Despite the recognition by many researchers that cerebral palsy (CP) is rarely related to obstetric malpractice, there are many instances where obstetricians face litigation when a child is diagnosed with cerebral palsy following a difficult delivery. The aim of this paper is to review relevant research papers to aid practitioners involved in obstetric malpractice litigation. It is also prudent to question the feasibility of costs for long-term care for children with disabilities being met through the legal process. [Copyright &y& Elsevier]

Background: Injuries to the bile duct during laparoscopic cholecystectomy are often a cause of malpractice litigations. Methods: A total of 13 legal verdicts as a result of bile duct injury from 1996 to 2009 were reviewed. Comments on the verdicts and the opinions of expert witnesses were analyzed. Results: Out of 13 claims, 7 were upheld and 6 were rejected. Most expert witnesses from 1996 to 2002 stated that not carrying out a cholangiography and insufficient preparation of the cystic duct constituted a performance below the standard of care expected. Expert witness testimonies from 2004 to 2009, however, regarded injury to the bile duct as predominantly inherent to treatment. Conclusion: With the expansion and acceptance of laparoscopic interventions, changes in the results of malpractice litigation have become evident. In contrast to the phase during establishment of the technology, an injury to the bile duct is nowadays judged predominantly as inherent to treatment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To illustrate the psychological effect of grievances and negligence litigation on doctors sued by Legal Medicine Organization Complaints Commissions. Methods: Retrospective survey regarding the views of a large sample of Iranian sued physicians by using a piloted anonymous questionnaire. Results: The answer rate was 77.5%. Seventy-six per cent of participants encountered monitoring criteria for psychiatric disturbance. Rate of psychological morbidity in between study cluster was much higher than Iranian general population, Iranian non-sued general practitioners, interns and medical students. There was, however, minimal dysfunction of work, public or family life. The survey form to estimate the doctor’s realization of lawful risk displayed that doctors yet misconceive medico-legal risk. Doctors being sued or having legal protests against them depict the process as an exceedingly demanding event. Conclusions: Grievance or legal action is unusual in the daily practice of doctors, but in today’s medico-legal domain they face a continuous possible threat. The threat of, or real, legal process can cause psychological, corporeal and behavioral practice changes. [Copyright &y& Elsevier]

Abstract: Malpractice litigation involving patients with carcinoma of the breast has been evaluated in United States of America (USA). The extent of litigation in breast cancer has not been published in UK and malpractice claims in relation to overall breast care have not been published before. We sought to study and evaluate all the litigation claims in relation to breast care with the National Health Service Litigation Authority (NHSLA) from May 1995 to September 2005. We also studied changes in litigation claims and outcomes in incidents reported before and after January 1, 2000. [Copyright &y& Elsevier]