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Lim YH, Saberi SA, Kamal K, Jalian HR, Avram M. Retrospective Analysis of US Litigations Involving Dermatologists From 2011 to 2022. Dermatol Surg 2024; 50:518-522. [PMID: 38416806 DOI: 10.1097/dss.0000000000004142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
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.
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Affiliation(s)
- Young H Lim
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | | | | | | | - Mathew Avram
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
- Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Boston, Massachusetts
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2
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Suvarnakar A, Raiker R, Pakhchanian H, Jenkins K, Hussain A. Characteristics of Litigations Involving Contact Dermatitis: An Exploratory Analysis. Dermatitis 2024; 35:167-172. [PMID: 37788399 DOI: 10.1089/derm.2023.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background: Contact dermatitis (CD) is one of the most common skin disorders, occurring in >20% of patients worldwide. Estimated cost burden for CD in the United States approaches $1 billion annually. Objective: To describe characteristics of litigation among patients with CD. Methods: Westlaw legal database for U.S. lawsuits was queried for lawsuits between the years 1983 and 2021 containing the keywords "dermatitis or eczema." Each lawsuit associated with CD was analyzed by plaintiff demographics, verdict, prosecution reason, payouts, and allergen implicated. Results: Of 98 cases, 61 met the inclusion criteria. Verdicts issued favored plaintiffs (42.6%) more than defendants (32.8%) with the remaining cases decided through settlements. If payout occurred, the mean was $246,310 (standard deviation [SD] = $798,536), the median was $20,000 (Q1 = $8,500, Q3 = $88,725, interquartile range = $80,225). The top reason for litigation was toxic exposure (n = 38, 62.2%), and common contact allergens associated with lawsuits were latex (n = 4, 20%), surgical tape (n = 4, 20%), and beauty products (n = 4, 20%). Conclusion: Common allergens associated with lawsuits include latex, surgical tape, and beauty products. Most CD cases adjudicated in the United States since 1983 are associated with toxic exposures.
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Affiliation(s)
- Aashka Suvarnakar
- From the Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Rahul Raiker
- West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Haig Pakhchanian
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Kendall Jenkins
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Aamir Hussain
- MedStar Washington Hospital Center/Georgetown University Dermatology Residency, Washington, District of Columbia, USA
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3
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Chen J, Zhang T, Feng D, Liu Y, Zhang T, Wang J, Liu L. A 9-year analysis of medical malpractice litigations in coronary artery bypass grafting in China. J Cardiothorac Surg 2023; 18:73. [PMID: 36782245 PMCID: PMC9926683 DOI: 10.1186/s13019-023-02172-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The coronary artery bypass grafting (CABG) is one of the high-risk litigated medical specialties. Further elucidating the causes behind these malpractice claims can help physicians avoid patient injury. This study analyzed CABG litigations occurred in different level hospitals to outline the basic characteristics, as well as present a analysis on the medical malpractice that result in lawsuits. METHODS This study utilized the "China Judgments Online" database to compile litigations from 2012 to 2021 across China. 109 cases related to the CABG were included in the study, and were analyzed for demographic, patient outcomes and verdict characteristics in different levels of hospitals. RESULTS The median age of plaintiff patient was 62 years, the median length of stay was 25 days, and the median responsibility ratio of the litigation cases was 30%. The average proportion of responsibility of national, provincial and municipal hospitals were 29.6%, 28.4% and 39.5% respectively, and the median days after surgery to death of that were 15, 9 and 5 separately. The top 5 postoperative complications in dispute cases were: low cardiac output syndrome, postoperative hemorrhage, non-surgical site infections, surgical site infections and arrhythmia. CONCLUSIONS The diagnosis and treatment capabilities of coronary artery bypass grafting in different levels of hospitals in China were inconsistent, and the treatment capabilities in prefecture-level hospitals were lower than that in national hospitals. The procedural error, failure to properly monitor the patient and diagnostic errors were common in CABG litigations. Postoperative complications related to surgical injuries and insufficient basic postoperative management lead to a higher responsibility proportion.
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Affiliation(s)
- Jie Chen
- grid.488137.10000 0001 2267 2324Medical School of Chinese People’s Liberation Army, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Medical Quality Management, Peking University People’s Hospital, Beijing, China
| | - Tianyi Zhang
- grid.414252.40000 0004 1761 8894Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Dan Feng
- grid.414252.40000 0004 1761 8894Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Yuehui Liu
- grid.414252.40000 0004 1761 8894Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Tao Zhang
- grid.411634.50000 0004 0632 4559Department of Vascular Surgery, Peking University People’s Hospital, Beijing, China
| | - Jingtong Wang
- Department of Medical Quality Management, Peking University People's Hospital, Beijing, China.
| | - Lihua Liu
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China.
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4
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Hibler BP, Eliades PJ, Kagha KC, Avram MM. Litigation Arising From Minimally Invasive Cosmetic Procedures: A Review of the Literature. Dermatol Surg 2021; 47:1606-1613. [PMID: 34417380 DOI: 10.1097/dss.0000000000003202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures. Understanding malpractice trends and reasons for litigation in cosmetic medicine is important to establish safeguards for patient care and minimize liability. OBJECTIVE Perform a comprehensive review of the literature on litigation associated with minimally invasive cosmetic procedures and discuss strategies to avoid facing a lawsuit. MATERIALS AND METHODS The authors searched PubMed databases using a variety of keywords to identify studies of lawsuits arising from minimally invasive cosmetic procedures through December 2020. RESULTS A total of 12 studies of litigation meeting inclusion criteria were identified: botulinum toxin (1), soft tissue fillers (3), lasers (5), body contouring/liposuction (1), chemical peels/dermabrasion (1), and sclerotherapy (1). Principle factors associated with litigation included negligence, lack of informed consent, vicarious liability for action of delegates, lack of communication, poor cosmetic result, failure to inform of risks, inappropriate treatment or dose, and failure to recognize or treat injury. CONCLUSION Understanding malpractice trends and reasons for litigation in minimally invasive cosmetic procedures can strengthen the patient-provider relationship, establish safeguards for patient care, and may minimize future risk of a lawsuit.
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Affiliation(s)
- Brian P Hibler
- Department of Dermatology, Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Boston, Massachusetts
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Karen C Kagha
- Department of Dermatology, Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Boston, Massachusetts
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mathew M Avram
- Department of Dermatology, Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Boston, Massachusetts
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5
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Vural S, Akay BN, Yaycıoğlu A, Bostancı S. Accelerated Use of Non-Surgical Techniques for Nevi Removal: Primum Non-Nocere. Dermatol Pract Concept 2021; 11:e2021117. [PMID: 34631266 DOI: 10.5826/dpc.1104a117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 10/31/2022] Open
Affiliation(s)
- Seçil Vural
- Koç University, School of Medicine, Department of Dermatology and Venereology
| | - Bengü Nisa Akay
- Ankara University, Faculty of Medicine, Department of Dermatology and Venereology
| | - Arda Yaycıoğlu
- Koç University, School of Medicine, Department of Dermatology and Venereology
| | - Seher Bostancı
- Ankara University, Faculty of Medicine, Department of Dermatology and Venereology
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6
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Elsner P, Meyer J. Nachexzision eines Basalzellkarzinoms an der falschen Lokalisation. AKTUELLE DERMATOLOGIE 2021. [DOI: 10.1055/a-1345-3738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungEine Patientin stellte sich in der Sprechstunde einer dermatologischen Klinik wegen zweier Hautveränderungen im Bereich der Nase vor. Der behandelnde Dermatologe entfernte diese in Form tangentialer Abtragungen; die histologische Untersuchung ergab das Vorliegen eines Angiofibroms sowie eines Basalzellkarzinoms, welches nicht im Gesunden entfernt worden war. In Absprache mit der Patientin erfolgte eine Nachexzision. Diese wurde von einem zweiten Dermatologen der Klinik auf der Basis einer unklaren Dokumentation der Primärexzision an einer falschen Stelle durchgeführt.Die Patientin bemängelte die operative Behandlung; deshalb sei eine weitere Operation an der Nase erforderlich geworden. Die Schlichtungsstelle bestätigte, dass es fehlerbedingt zu einer nicht notwendigen Exzision an falscher Stelle mit entsprechender Narbenbildung sowie zu einem ohne den Fehler nicht erforderlichen weiteren Eingriff gekommen sei.Der an der falschen Lokalisation durchgeführte dermatochirurgische Eingriff („wrong site surgery“) ist ein in der Dermatochirurgie bekanntes Fehlergeschehen. Als Präventionsmaßnahme hat sich eine sog. „Time-out“ („Auszeit“) bewährt, wobei vor und ggf. während einer Operation diese unterbrochen wird zur Bestätigung des richtigen Patienten, Eingriffs und Ortes. Im vorliegenden Fall wurde die Wahl des falschen Nachexzisionsortes gefördert durch eine unklare Dokumentation der Primärexzision und eine fehlende Kommunikation zwischen den behandelnden Dermatologen über die korrekte Exzisionsstelle. Gemäß § 630 h BGB tritt eine Beweislastumkehr bei der Haftung für Behandlungs- und Aufklärungsfehler ein, wenn es sich um ein sog. „voll beherrschbares Risiko“ handelt; um ein solches handelt es sich bei einer Exzisionsstellenverwechslung. Der berichtete Fall beleuchtet gleichzeitig die Probleme der ärztlichen Arbeitsteilung; nach der sog. „horizontalen Arbeitsteilung“ darf jeder Facharzt zunächst darauf vertrauen, dass ein anderer an der Behandlung beteiligter Facharzt seine Pflichten aus dem Behandlungsvertrag korrekt erfüllt. Entstehen jedoch Zweifel, wie im vorliegenden Fall bzgl. der Dokumentation der korrekten Exzisionsstelle, darf der zweitbehandelnde Arzt nicht unbesehen handeln, sondern muss sich selbstverantwortlich der richtigen Diagnose, in diesem Fall bzgl. der Lokalisation des Basalzellkarzinoms, vergewissern. Durch eine Nachfrage beim erstbehandelnden Dermatologen wäre der Behandlungsfehler zu vermeiden gewesen.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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7
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Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, Arnolda G, Wiles LK, Theodorou T, Tran Y, Lystad RP, Hatem S, Long JC, Rapport F, Pantle A, Clay-Williams R. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open 2021; 11:e050377. [PMID: 34429317 PMCID: PMC8386219 DOI: 10.1136/bmjopen-2021-050377] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/05/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners. DESIGN Systematic review. DATA SOURCES Ovid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched. RESULTS Sixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out. CONCLUSIONS It is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor's risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm. PROSPERO REGISTRATION NUMBER PROSPERO registration number: CRD42020182045.
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Affiliation(s)
- Elizabeth E Austin
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Vu Do
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Ruqaiya Nullwala
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Peter D Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Louise K Wiles
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Tahlia Theodorou
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Sarah Hatem
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Annette Pantle
- Medical Council of New South Wales, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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8
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Fogel AL, Lacktman NM, Kvedar JC. Skin Cancer Telemedicine Medical Malpractice Risk. JAMA Dermatol 2021; 157:870-871. [PMID: 34009267 DOI: 10.1001/jamadermatol.2021.1475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alexander L Fogel
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | | | - Joseph C Kvedar
- Department of Dermatology, Massachusetts General Hospital, Boston
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9
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Elsner P. Patientensicherheit in der Dermatologie: Definitionen und Fehlermonitoring. AKTUELLE DERMATOLOGIE 2021. [DOI: 10.1055/a-1385-3203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungMedizinethisch ist der Arzt nach dem „Nil nocere“-Prinzip verpflichtet, einem Patienten durch eine Behandlung zu nutzen und nicht zu schaden, auch wenn die Behandlung erfolglos sein mag. Das ärztliche Haftungs- und Berufsrecht fordert, dass eine Behandlung nach dem Standard eines sorgfältigen Facharztes zu erfolgen hat. Gleichwohl kommt es in Kliniken und Praxen immer wieder zu „vermeidbaren unerwünschten medizinischen Ereignissen“, die definiert sind als „Patienten schadende Vorkommnisse, die eher auf der Behandlung als auf der Erkrankung selbst beruhen und die durch einen Fehler verursacht sind“. Patientensicherheit als in der Medizin erstrebenswertes Handlungsziel bedeutet die Minimierung derartiger unerwünschter Ereignisse. Dies setzt voraus, dass unerwünschte Ereignisse und die zu ihnen führenden Risikosituationen erfasst und analysiert werden; dafür eignen sich Register wie „Critical Incidence Reporting Systems“ (CIRS) und die Fälle der Gutachterkommissionen bei den Landesärztekammern. Die Analyse von Gutachten zu Behandlungsfehlervorwürfen gegen Dermatologen ergab, dass nicht operative Therapiefehler an der Spitze der bestätigten Fehler stehen, gefolgt von Diagnostikfehlern und operativen Therapiefehlern. Aus diesen Erkenntnissen können konkrete Empfehlungen für Initiativen zur Verbesserung der Patientensicherheit in der Dermatologie abgeleitet werden.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
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10
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Watari T, Tokuda Y, Mitsuhashi S, Otuki K, Kono K, Nagai N, Onigata K, Kanda H. Factors and impact of physicians' diagnostic errors in malpractice claims in Japan. PLoS One 2020; 15:e0237145. [PMID: 32745150 PMCID: PMC7398551 DOI: 10.1371/journal.pone.0237145] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 07/21/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Diagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims. METHODS We analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors. RESULTS All 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality." CONCLUSIONS Cases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms as well as internal medicine and surgery departments and were initially considered to be common, mild diseases.
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Affiliation(s)
- Takashi Watari
- Postgraduate Clinical Training Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Yasuharu Tokuda
- Okinawa Muribushi Project for Teaching Hospitals, Okinawa, Japan
| | | | - Kazuya Otuki
- Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kaori Kono
- Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Nobuhiro Nagai
- Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kazumichi Onigata
- Postgraduate Clinical Training Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Hideyuki Kanda
- Department of Environmental Medicine & Public Health, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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11
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Tripathi R, Ezaldein HH, Rajkumar K, Bordeaux JS, Scott JF. Characteristics of State and Federal Malpractice Litigation of Medical Liability Claims for Keratinocyte Carcinoma, 1968 to 2018. JAMA Dermatol 2020; 155:812-818. [PMID: 31090874 DOI: 10.1001/jamadermatol.2019.0430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance The prevalence of keratinocyte carcinoma (KC) exceeds that of all other malignant neoplasms combined. Despite the steady rise of payments for medical malpractice liability claims over time, data regarding the characteristics of malpractice litigation for KC are scarce. Objective To identify state and federal appellate medical malpractice liability cases for KC and determine the factors associated with the verdicts. Design, Setting, and Participants This retrospective review of KC-related malpractice litigation under state or federal jurisdiction reviewed the LexisNexis Academic database of state and federal cases, legal reviews, and case law. All appellate medical malpractice cases at the state and federal levels involving basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) from January 1, 1968, through December 31, 2018, were identified. Main Outcomes and Measures Demographic characteristics of the cases and plaintiffs, verdict, health care specialty of the defendant, setting of the litigation, rationale for the lawsuit and verdict, factors associated with the case outcome, and monetary payout in cases won by the plaintiff. Results In total, 83 cases were included in our analysis (34 BCC cases and 49 SCC cases; 47 [57%] male plaintiffs). Sixty-two cases (75%) were decided in favor of the defendant. More KC-related malpractice cases were won by defendants in more recent years than were won by plaintiffs (mean year, 2004 [SD, 11 years] vs 1998 [SD, 14 years]; P = .03). Twenty-five cases (30%) each occurred in the Northeast and the South, and 45 (54%) involved private practices. Most cases involved KCs occurring on the face, head, and/or neck (39 [47%]), the genitalia (22 [27%]), or the extremities (15 [18%]). More than half of defendants were dermatologists (19 [23%]), family medicine physicians (15 [18%]), or oncologists (8 [10%]). Jurisprudence for KC-related malpractice cases most often occurred at the state level (49 [59%]). The most common causes of litigation were failure to diagnose (18 [22%]), misdiagnosis (18 [22%]), and delay in treatment (11 [13%]). More female than male plaintiffs won their malpractice cases (11 of 35 [31%] vs 5 of 43 [12%]; P = .03). More cases involving SCC than BCC led to a decision favoring the plaintiff (13 of 47 [28%] vs 3 of 31 [10%]; P = .05). In cases won by the plaintiff, the median monetary payout was $179 654 and the mean payout was $909 801 (range, $11 537-$5 320 161). Conclusions and Relevance This study sheds light on the characteristics and settings of KC malpractice litigation claims, which is vital information for discovering potential areas of quality improvement, patient safety initiatives, and education for patients and health care professionals.
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Affiliation(s)
- Raghav Tripathi
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Harib H Ezaldein
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - Jeremy S Bordeaux
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jeffrey F Scott
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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12
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Singh P, Silverberg J. Underscreening of depression in U.S. outpatients with atopic dermatitis and psoriasis. Br J Dermatol 2019; 182:1057-1059. [DOI: 10.1111/bjd.18629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P. Singh
- Department of Dermatology Feinberg School of Medicine Northwestern University Chicago IL, U.S.A
| | - J.I. Silverberg
- Department of Dermatology George Washington University School of Medicine & Health Sciences George Washington University Washington D.C. U.S.A
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13
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Tripathi R, Mazmudar RS, Ezaldein HH, Bordeaux JS, Scott JF. Prison malpractice litigation involving dermatologists: A cross-sectional analysis of dermatologic medical malpractice cases involving incarcerated patients during 1970-2018. J Am Acad Dermatol 2019; 81:1019-1021. [DOI: 10.1016/j.jaad.2019.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/01/2019] [Accepted: 02/09/2019] [Indexed: 11/28/2022]
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14
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Tripathi R, Xiang L, Mazmudar RS, Ezaldein HH, Bordeaux JS, Scott JF. An analysis of state and federal psoriasis malpractice litigation in the United States from 1954 to 2018. J Eur Acad Dermatol Venereol 2019; 33:e488-e490. [PMID: 31310692 DOI: 10.1111/jdv.15812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- R Tripathi
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - L Xiang
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - R S Mazmudar
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - H H Ezaldein
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - J S Bordeaux
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - J F Scott
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Arimany Manso J, Martin Fumadó C, Mascaró Ballester J. Medical Malpractice Issues in Dermatology: Clinical Safety and the Dermatologist. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Arimany Manso J, Martin Fumadó C, Mascaró Ballester JM. Medical Malpractice Issues in Dermatology: Clinical Safety and the Dermatologist. ACTAS DERMO-SIFILIOGRAFICAS 2018; 110:20-27. [PMID: 30077393 DOI: 10.1016/j.ad.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/17/2018] [Accepted: 06/22/2018] [Indexed: 12/11/2022] Open
Abstract
Clinical safety and medical liability are first-order concerns in today's medical practice. It is important to understand the circumstances under which medical acts fail to live up to the accepted standard of care and to recognize the impact that malpractice claims have on physicians. Practitioners must also grasp the concept of medical error, studying malpractice claims in order to identify the areas where improvement is needed. The risk of accusations of malpractice in dermatology is comparatively low, both in Spain and worldwide. However, a great variety of clinical scenarios in dermatology can potentially give rise to a claim, and malignant melanoma is most susceptible to risk. Dermatologists should know which actions during clinical consultation merit particular attention and care. Clinical practice carries inherent risk of malpractice claims, but taking certain recommended precautions can prevent them.
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Affiliation(s)
- J Arimany Manso
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Unidad de Medicina Legal y Forense, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España.
| | - C Martin Fumadó
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Departamento de Medicina, Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España
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