Learning from an analysis of closed malpractice litigation involving myocardial infarction

Wu, Keng‐Liang; Yen, Yung-Lin; Wu, Chien-Hung; Hwang, Chi-Yuan; Cheng, Shih-Yu

doi:10.1016/j.jflm.2017.04.003

Cited by 11 publications

(4 citation statements)

References 19 publications

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“…A 2017 retrospective analysis of malpractice claims involving myocardial infarction found that misdiagnosis was the most common claim. The analysis also found that delayed diagnosis resulted in a plaintiff verdict if the physician either failed to work up a patient with coronary artery disease risk factors presenting with the cardinal symptom of chest pain or ischemic heart disease or if the physician failed to perform indicated treatment in a timely manner to avoid disease progression [20]. Of note, cited bases for litigation are obtained from legal proceedings, and the semantics used in law may differ from those in medicine.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Analysis of Malpractice Litigation in Cardiology Using Case Summaries Through a National Legal Database Analysis

Patel

Rynecki

Eidelman

et al. 2019

Cureus

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IntroductionPhysicians are increasingly practicing defensive medicine as a response to society’s litigious climate. This study sought to characterize cardiology malpractice claims and elucidate the allegations underlying the use of defensive medicine.MethodsThe WestlawNext™ database was queried to obtain state and federal jury verdicts and settlements related to medical malpractice and cardiology that occurred in the United States between 2010 and 2015. Cardiology cases were identified using the search terms “medical malpractice” and “cardiology” and reviewed by two individuals utilizing available case documents. Duplicate and nonpertinent cases were excluded. Binary logistic regression models were created to predict the likelihood of defendant verdict, plaintiff verdict, and settlement based on the various reasons for litigation cited.ResultsInclusion criteria were met in 166 cases. The plaintiffs were predominantly male (94 cases; 56.6%), and the average patient age was 53.3±17.5 years. More than half of the cases involved a cardiologist as a defendant. The most common reasons for litigation were: failure to treat (129; 77.7%), failure to diagnose (115; 69.3%), failure to refer/order diagnostic tests (107; 64.5%), and patient death (118; 71.1%). Among cases tried for failure to diagnose, the most commonly missed diagnosis was myocardial infarction. Cases most commonly resulted in a defendant verdict (94; 56.6%). However, odds of a plaintiff verdict were significantly higher when failure to diagnose was alleged with an odds ratio (OR) of 7.60 (95% confidence interval 1.14 - 50.87, p = 0.0365).ConclusionsFailure to diagnose remains a commonly alleged base for litigation. In conclusion, our analysis suggests increased training for non-cardiologists in the recognition of the acute coronary syndrome and enhanced awareness of inherent biases among all physicians may facilitate reducing missed diagnoses.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Analysis of Malpractice Litigation in Cardiology Using Case Summaries Through a National Legal Database Analysis

Patel

Rynecki

Eidelman

et al. 2019

Cureus

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“…The analyzed contents in each litigated case included basic information of the plaintiffs and the defendants, clinical characteristics, and legal issues. The issues of primary disputes were categorized as follows 11 : Misdiagnosis was defined in the cases presenting failure to suspect the skin cancer at the initial diagnosis; delayed diagnosis was stipulated in the cases that considered the skin cancer as the initial diagnosis, but failed to make the final diagnosis appropriately; performance error was inferred from the cases with improper management even after proper diagnosis. The detailed analysis of each precedent was performed independently by a dermatologist (Cho SI) for the dermatological issues and by a researching physician (Shin SH) for the medical law and ethics.…”

Section: Methodsmentioning

confidence: 99%

Analysis of Judicial Precedents Cases Regarding Skin Cancer from 1997 to 2017 in Republic of Korea

et al. 2019

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Background Both medical disputes and the incidence of skin cancer are increasing in Korea. Objective The aim of this study was to figure out the medical litigation related to skin cancer and propose a method to prevent the medical disputes. Methods Skin cancer-related judgments were searched by The Supreme Court of Korea's Written Judgment Management System based on the keywords for skin cancer. The search system included sentenced cases at the Lower Courts, the Appellate Courts, and the Supreme Court from 1997 to 2017. Results Seven cases were selected as the litigation cases related to skin cancer. Four cases (57.1%) presented malignant melanoma, while the rest presented squamous cell carcinoma, metastatic skin cancer, and peripheral T cell lymphoma (1 case in each). Four cases resulted in death from cancer metastasis, and 3 cases presented as sequelae. The legal issues related to the medical disputes could be categorized as follows: misdiagnosis, delayed diagnosis, performance error, and lack of informed consent. Delayed diagnosis and lack of informed consent were the most common issues (n=4) in the precedents. Five cases (71.4%) were sentenced the awarded amounts to the plaintiff, including 2 cases of settlement decision. The average awarded amount was 42,553,644±27,567,455 Korean won. Conclusion Physicians should pay attention to the cases of the skin cancer to prevent medical malpractice and disputes. The practices pertaining to proper diagnosis, treatment plans, and obtaining an informed consent should be followed during the course of treating skin cancer.

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“…A 2017 study of closed malpractice claims associated with AMI in Taiwan found that misdiagnosis was the most common dispute associated with claims. 27 In summary, ACS represents a disease process with increased morbidity and mortality to the patient if the diagnosis is missed. It is a relatively common source of litigation with high malpractice recovery and therefore represents a significant medicolegal risk.…”

Section: Electrocardiograms and The Diagnosis Of Acute Myocardial Infarctionmentioning

confidence: 99%

Three Cases of Emergency Department Medical Malpractice Involving “Consultations”: How Is Liability Legally Determined?

Aldalati

Bellamkonda

Moore

et al. 2021

Clinical Practice and Cases in Emergency Medicine

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Learning from an analysis of closed malpractice litigation involving myocardial infarction

Cited by 11 publications

References 19 publications

A Qualitative Analysis of Malpractice Litigation in Cardiology Using Case Summaries Through a National Legal Database Analysis

A Qualitative Analysis of Malpractice Litigation in Cardiology Using Case Summaries Through a National Legal Database Analysis

Analysis of Judicial Precedents Cases Regarding Skin Cancer from 1997 to 2017 in Republic of Korea

Three Cases of Emergency Department Medical Malpractice Involving “Consultations”: How Is Liability Legally Determined?

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