Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Abstract

Background/Aims: Possible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis. Methods: A total of 13 cases (20 judgments) found in the Supreme Court of Korea's Written Judgment Management System from 1998 to 2017 were analyzed. Results: Coronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won. Conclusions: Physicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

Analysis of judicial precedent cases regarding epidural injection in chronic pain management in Republic of Korea

“…This distinction may be due to the nature of our data, that is, lawsuit judgements versus claims. In addition, the average claim and awarded amounts in our study (average amount of claims: $359 915; average amount awarded in judgements: $170 842) were higher than those reported in lawsuit cases of orthopedic, general surgery, and coronary interventions in Korea 17–19…”

Association between hospital legal constructions and medical disputes: A multi-center analysis of 130 tertiary hospitals in Hunan Province, China

“…Previous studies have demonstrated that misdiagnosis, a lack of informed consent, therapeutic plan errors, procedures that result in serious complications, and patient–physician mistrust were significantly associated with medical disputes ( 9 , 31 , 32 ). These factors may be very useful in guiding medical management.…”

Medicolegal implications from litigations involving necrotizing fasciitis

“…First, the details of the medical processes were not accurately assessed due to the characteristics of judgments, which described only the details required for the decision. Nevertheless, we reviewed some previous studies regarding medical malpractice and judicial precedents [15][16][17][18][19][20][21][28][29][30] and tried to set appropriate variables for quantitative analysis and structure for qualitative analysis. Second, there were only a few litigation cases related to NF, meaning a longer period was needed to retrieve cases; therefore, judgments in the past might not reflect the current clinical practice.…”

“…Subsequently, the researchers categorized the cases into 3 groups based on medical accident, the occurrence of NF, and breach of duty. For medical accidents, we analyzed the following variables that have been used in previous studies [15][16][17][18][19][20][21][22]: the yearly distribution of NF cases, the period of the resolution, type of medical institution, specialized department, patient's sex and age, and the rate of loss of labor capacity as a result of damage. The decision, limitation of liability, and the amount claimed and awarded relating to the medical accident were analyzed.…”