Trends in US malpractice payments in dentistry compared to other health professions – dentistry payments increase, others fall

Association of Practice Setting and Scholarly Activity With Medicolegal Claims in Otolaryngology-Head and Neck Surgery

OBJECTIVE

To characterize the association between scholarly activity, academic rank, practice setting, and malpractice claims among otolaryngologists over the past decade.

METHODS

Data was extracted from the two legal databases, WestLaw and LexisNexis. The records were obtained from January 2010 to January 2020. Scopus and PubMed databases were used to identify bibliometric data.

RESULTS

Of the 102 malpractice cases identified, 77.5% (N = 79) were ruled in favor of the defendant, 13.7% (N = 14) in favor of the plaintiff, and 8.8% (N = 9) were settled outside of the court. A total amount of $46,533,346.82 was rewarded to plaintiffs in 14 cases. Endoscopic sinus surgery was the procedure associated with the most malpractice claims (N = 16). Alleged improper performance (N = 51) was the most common underlying reason for litigation. Of the 102 defendant surgeons, 82 (80.4%) were in community/private settings. Among the 14 cases in that a surgeon was found at fault, 13 (92.8%) were in the community/private setting. Among the surgeons with at least one publication, the mean Hirsch Index (h-index) was 8.2. There was a statistically significant correlation between the mean h-index and litigation outcome (95% CI: -8.9 to -0.9, P = .017).

CONCLUSION

Our analysis showed that most malpractice litigations were among otolaryngologists practicing in community/private settings. We also found that higher scholarly activity measured by the h-index was associated with verdicts in favor of the defendant/surgeon. This study was limited by not all-inclusive aspects of the legal databases that were used, the small sample size, and the lack of multivariable analysis.

Court decisions in criminal proceedings for dental malpractice in Taiwan

BACKGROUND/PURPOSE

Malpractice claims place heavy economic and emotional burdens on both dentists and patients. Recently, medical malpractice lawsuits are decreasing in prevalence but increasing in severity. The percentage of dental malpractice payments is also growing among the health profession. The present study aimed to explore criminal convictions in dental malpractice litigation and to analyze the factors affecting the judgment in dental disputes in Taiwan.

METHODS

The keywords "dentist," "professional negligence," "medical malpractice," and "professional liability" were used to search Taiwan's Law and Regulations Retrieving System for criminal dental malpractice cases in all district courts from January 1, 2000 to June 30, 2021. The eligible judgments were summarized and analyzed.

RESULTS

Overall, 425 cases were identified, with 28 dental disputes included in the final analysis. The dentists lost in 10 cases (35.7%). The average claim time was 36.75 ± 16.34 months. Taipei and Taichung dealt with more lawsuit cases (n = 8). Local clinics were the most common institution of the defendants (75%) and had the highest number of convictions (n = 9). Implant dentistry was the most common specialty involved. Expert testimony of the Medical Review Committee (MRC) had a high K coefficient of agreement with court judgments regarding professional negligence (p < 0.001).

CONCLUSION

The overall criminal conviction rate was 35.7%. Implant therapy and local clinics had the highest rate of lawsuits and a considerably higher conviction rate. All guilty dentists were fined or given probation. The court judgments were highly consistent with the expert testimony of the MRC.

Professional legislation knowledge of dentists and psychological effects of negligence

INTRODUCTION

The aim of the present study was to evaluate the extent to which a group of general dentists and specialists had knowledge of the professional laws and psychological effects of negligence on them.

MATERIALS AND METHODS

The sample in this cross-sectional study consisted of 400 dentists (General dentists and specialists) in Isfahan city, Iran. Having designed the questionnaire and confirmed its validity and reliability, we published online to be completed by the dentists. The obtained data were analyzed using descriptive statistics, t-test, and ANOVA test. Optimal knowledge was determined to be 75%, and P-value<0.05 was considered to be statistically significant.

RESULTS

The majority of the dentists (75%) had poor and very poor knowledge. The mean score of knowledge (range: 0-21, maximum obtainable: 24) was 9.58 ± 4.5. Sixty dentists (15%) reported they had experienced negligence. Further, 278 (69.5%) reported they had somehow experienced the occurrence of malpractice during their practical experience. Legal negligence was more prevalent among the general dentists than specialists (17.8 VS 8%, p < 0.001). Regarding the legal complaint history, a significant difference was observed between the males and females (P = 0.015) and among different categories of work experience years (P = 0.000). Moreover, among those who had a history of a legal complaint, 96.7% showed psychological symptoms, 70% had physical symptoms, and 80% displayed social symptoms related to the stress following legal complaints.

CONCLUSION

Findings of this study indicated that refining the knowledge of the rules and regulations of the dental profession should be enhanced by considering appropriate training courses in the curricula and continuous education programs. More than half of the participants considered themselves guilty of negligence in this regard.

Dentists' Legal Liability and Duty of Explanation in Dental Malpractice Litigation in Japan

Introduction

Dental litigation accounts for approximately 10% of medical cases in Japan. This study sought to identify factors related to dentists’ legal liability in Japan, including their duty to explain procedures and treatments to their patients.

Methods

We analysed court decisions in 166 dental malpractice cases litigated in Japan between 1978 and 2017. To identify factors related to the legal liability of dentists, an analysis was performed to evaluate the associations among patient characteristics, dentist characteristics, litigation, and dentists’ explanatory behaviour.

Results

Of the 36 cases related to dentist liability, the study identified 23 cases (63.9%) of litigation in which the dentists were found to be in violation of their duty to provide an explanation. Regarding the severity of injury, the ratio of death and permanent disability was significantly higher in decisions in which the purpose of the explanation was something other than obtaining the patient's consent compared with decisions to obtain the patient's consent (P = .014).

Conclusions

In cases in which the dentist was found legally responsible, the proportion of cases involving procedural negligence with the explanation of medical guidance was significantly higher. Dentists should pay careful attention not only to the patient's consent but also to their explanations, including “medical guidance.” Moreover, they should recognise that inappropriate explanations correlate with serious errors.

The Indian dental litigation landscape: An analysis of judgments on dental negligence claims in Indian Consumer Redressal Forums

INTRODUCTION

Dental malpractice/negligence litigations against dentists in India is not widely studied. The aim of this study is to report the Indian dentist related litigation landscape in consumer redressal forum (CRF) and to understand more of the nature of the same.

MATERIAL AND METHOD

111 cases of judgments of dental malpractice in Indian CRF were collected. Useful information was extracted, reported in a grid and statistically analyzed. Data was compared by claim, specialty, treatment offered, days lapsed and compensation awarded. P ≤ 0.05 was taken as statistically significant.

RESULTS

In all, 44 (39.63%) dentists were found guilty. Thirty dentists had produced at least one evidence in their favor. Among them, 23 outcomes were in dentist's favor.(P = 0.02) The mean wait for final judgment was 1945 ± 1286(193-6762) days. The mean compensation claimed was INR 577287 ± 905898. Presence of evidence (dentists/patients) had an impact on the days to reach a judgment as well as compensation.

CONCLUSION

Indian dental litigation landscape CRF has been described for the first time. We identified that CRF litigation of dental malpractice are few, as compared to number of procedures performed in India. Oral surgical procedures were often involved and 40% of instances, dentists were guilty and mean compensation awarded was INR 103998 ± 158976.