|
ScienceWeek
MEDICAL MALPRACTICE 2004
Selected Abstracts and Titles
--------------------------------
J Gerontol A Biol Sci Med Sci. 2004 Jul;59(7):B674-81.
Anti-aging medicine: the legal issues: legal issues associated with the current and future practice of anti-aging medicine.
Reisman NR.
JD, 6624 Fannin, Suite 1600, Houston, TX 77030. drreisman@hotmail.com
This article addresses legal issues and laws that govern physicians, medications, drugs, and the safety of patients in age management and anti-aging medical practices. Age management programs continue to increase and attract more patients despite the lack of scientific proof of their medical benefits. The use of growth hormone, other medications, and supplements is widely reported, although prohibited by the Food and Drug Administration for the treatment of anti-aging. The categories of potential legal liability presented in this article include False Expectations, Fraud, Negligence-Malpractice, Warranty Issues, Product Liability, Human Growth Hormone Usage, and Agency (employee) Issues. This article attempts to identify potential areas of liability for the age management practitioner and the patient seeking such care.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
J Med Pract Manage. 2004 May-Jun;19(6):324-8.
Seven steps to reduce your malpractice risk.
Reiboldt JP.
The Coker Group, 11660 Alpharetta Highway, Suite 710, Roswell, GA 30076, USA. jreiboldt@cokergroup.com
More than ever, malpractice is one of the biggest concerns in the medical community. High premiums have caused providers to reduce services and even close shop in some areas or specialties, where premiums have increased by 100 to 200 percent. At this writing, the federal government is stymied in its efforts to provide relief. So what is a health-care organization to do? This article presents seven steps that may not lower premiums, but will help an organization decrease the likelihood of being entangled in a long, drawn-out lawsuit that has little or no medical basis.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
J Ky Med Assoc. 2004 Jul;102(7):300-1.
Physician countersuits in medical malpractice cases.
Appenfelder P.
Stites & Harbison, USA.
The KMA House of Delegates passed Resolution 2003-35 in which the KMA was directed to draft and publish legal guidelines regarding when a suit may be brought against an attorney or plaintiff for filing a frivolous lawsuit against a physician. Thefollowing material, prepared by Peggy Appenfelder of the lawfirm of Stites & Harbison, discusses that issue.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Ann Health Law. 2004 Summer;13(2):623-32; discussion 633-46
A physician's perspective on the medical malpractice crisis.
Craig A.
Loyola University Chicago School of Law, USA.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
J Contemp Health Law Policy. 2001 Winter;18(1):297-322
Fitting a square peg in a round hole: why traditional tort principles do not apply to wrongful birth actions.
Bernstein P.
The Catholic University of America, Columbus School of Law, USA.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Z Arztl Fortbild Qualitatssich. 2004 May;98(3):226-9; discussion 230-1, 236-7.
[Do clinical guidelines and economic restrictions on health care affect the criminal liability of health care professionals?]
[Article in German]
Erlinger R.
Ulsenheimer Friederich Rechtsanwalte, Maximiliansplatz 12,80333 Munchen. erlinger@uls-frie.de
Criminal liability in connection with clinical guidelines relates to several different aspects: (1) It refers to the guideline authors' liability under criminal law in the case of faulty guidelines. (2) Guidelines do not constitute legally binding rules. They can only contribute to determining the standard for medical specialists. (3) There can and must not be any reversal in the burden of proof with criminal proceedings. (4) In case of a deviation from guidelines and a related breach of duty, the subjective aspect of negligence (i.e. the recognizability of danger) can often be inferred from the knowledge of the respective guideline that we can reasonably expect of the physician. (5) No physician who has adhered to the guidelines can regularly be accused of (subjective) negligence. (6) Problems may be encountered in cases where the topic in question has not been covered, but only peripherally touched upon by guidelines. For the sake of uniformity in our legal system, the individual physician must not be held criminally responsible for the lack of economic means. Possible solutions include: (1) relating the standard to the practically instead of the theoretically feasible, (2) investigating to what extent criminal liability may be limited by acceptability and possibility. The complete refusal to provide medical care under inadequate conditions may increase the endangerment of legally protected rights and therefore be unacceptable. Attempts to improve structures towards the standard may be regarded as meeting the requirements under criminal law.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Z Arztl Fortbild Qualitatssich. 2004 May;98(3):222-6; discussion 230-1, 236-7. Related Articles, Links
[The influence of medical standards, medical guidelines and economic restrictions on the standard of legal liability]
[Article in German]
Kern BR.
kern@rz.uni-leipzig.de
First we will have to identify the components determining the standard for medical liability in civil law cases. The civil courts have so far uniformly regarded the medical standard defined by physicians themselves as the standard of legal liability. Medical standards are based on scientific knowledge, practical experience and professional acceptance. Clinical guidelines can but need not necessarily reflect medical standards. Moreover, they cannot establish a standard. Second, on this basis the question will be whether economic restrictions should be allowed to alter the standard of legal liability. The answer depends, namely on what is meant by economic restrictions--rationalising or rationing? Rationalising need not be inconsistent with the standard. There are contradicting opinions in the legal literature about whether rationing is considered permissible. With regard to our social insurance system some authors point out that the highest possible standard is established by the statutory health insurance. With reference to the civil law, though, others demand that the medical standard must be given top priority. In accordance with the latter opinion rationing is only permitted in cases of a natural shortage of resources. Shortage of economic resources must not influence the standard of legal liability.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Z Arztl Fortbild Qualitatssich. 2004 May;98(3):185-90; discussion 190-2, 214-5. Related Articles, Links
[Economisation of medicine--standards and guidelines: adverse effects and their legal implications]
[Article in German]
Hess R.
Evidence-based clinical guidelines are recommendations for physicians and as such only of limited use as binding standards for monitoring the quality of their own achievements. When the Federal Joint Committee translates such guidelines into directives for physicians, hospitals, sickness funds and the insured they must consider the legal quality of such guidelines in order to ensure that physicians may exercise discretion to the extent necessary to providing individual treatment. Evidence-based medical guidelines are suitable means of ensuring quality. They are also intended to guide physicians on the efficiency of their services. But combining clinical guidelines as disease profiles of DMPs with the risk adjustment system of sickness funds or an instrument of selective contracts between sickness funds and physicians carries the risk of excessive bureaucracy and limiting the clinical freedom of physicians.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Vascular. 2004 Mar;12(2):89-91.
The American Board of Vascular Surgery and the law: fact and fiction.
Brown OW.
Department of Surgery, Section of Vascular Surgery, William Beaumont Hospital, Royal Oak, MI, USA. OWBMD@aol.com
The need for the establishment of an independent American Board of Vascular Surgery (ABVS) remains controversial. The controversy involves both medical and legal issues. These issues include medical malpractice, the attempt to create a "monopoly" by vascular surgeons, and the hospital credentialing of surgeons to perform vascular procedures. In this article, the legal impact of an independent ABVS on the filing of medical malpractice suits against vascular surgeons is explored. In addition, the legal criteria necessary to establish a monopoly, as well as criteria for hospital credentialing, are also reviewed. The results of this legal analysis are, first, that the establishment of an independent ABVS may well lead to a decrease in the number of frivolous lawsuits filed against vascular surgeons. Second, the establishment of an ABVS does not constitute the creation of a monopoly. Finally, hospital credentialing should not, and will not, be directly affected by the establishment of an independent ABVS.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Mod Healthc. 2004 Jun 28;34(26):18.
Physicians. Paying the price. Practices consider surcharges to combat high cost of malpractice insurance.
Romano M.
Publication Types: News
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
J R Army Med Corps. 2000 Feb;146(1):33-6
Medico-legal issues surrounding medical countermeasures used in the Gulf War--part 1.
Galbraith SN.
Army Medical Directorate (Medico Legal), London.
When the multinational force deployed to the Gulf after Iraq's invasion of Kuwait in 1990, military intelligence assessed the Iraqi's as possessing and being capable of using weapons of mass destruction. There was judged to be a real threat that chemical weapons, especially nerve agents, and certain biological weapons would be used. Coalition countries attempted to reduce the effects by the use of medical countermeasures. Since the Gulf conflict a series of medico legal problems from this policy have arisen; some of which have formed the basis of claims against MOD. In this paper I shall review how consent to treatment may have been modified in the military operational context and by the interface with military law. I shall look at the issues of clinical negligence and how duty of care may be affected. In the next article I shall look at relevant employment law; briefly review how medicines regulatory provision applies to medical countermeasures, whether they were properly licensed and whether in any case this applied to the Ministry of Defence in the context of deployment to the Gulf War.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
J Personal Disord. 2004 Jun;18(3):248-56.
Suicide, suicide litigation, and borderline personality disorder.
Gutheil TG.
The Department of Psychiatry and Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School, Brookline, MA 02446, USA. gutheiltg@cs.com
In the category of malpractice liability affecting mental health practitioners of all disciplines, malpractice based on suicide is the leading claim by a significant margin. Our discussion here will be organized in two sections. First, we consider the theory, practice, and psychology of malpractice litigation itself in relation to suicide. Second, we describe how those basic principles apply to patients with borderline personality disorder.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Saudi Med J. 2004 Jul;25(7):901-906.
Medical liability. The dilemma of litigations.
Alsaddique AA.
Assistant Professor of Surgery, Consultant Cardiac Surgeon, Division of Cardiac Surgery, College of Medicine and King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (1) 4671575. Fax. +966 (1) 4689493. E-mail: alsadd@hotmail.com
OBJECTIVE: Most if not all of the physicians are ill prepared when it comes to facing a medical litigation. Having witnessed that first hand on numerous occasions made me decide to write on this issue to offer some insight and advice on the matter as it is obvious no one is immune in the medical profession. In addition, the number of medical litigation cases is on the rise. There is no doubt that the matter is of great importance not only to doctors, medical and dental students but also to other health care workers. METHODS: The data of the cases submitted to the Medico-legal committee of the Ministry of Health, Riyadh, Kingdom of Saudi Arabia from various parts of the country for the period 1420 through to 1423 H (1999-2003) were examined and analyzed. A total of 2223 cases were referred to the various committees over the past 4-years for considerations. RESULTS: Obstetrics lead the way in being the most litigation prone medical specialty. Surgery takes the second place followed by internal medicine pediatrics being the fourth in order of frequency. The other specialties are some where in between. Least number of malpractice lawsuits were filed against the dental profession. CONCLUSION: Litigations can not be totally prevented but it could be limited to only the legitimate ones.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Surgery. 2004 Jul;136(1):100-2.
Ethics of serving as a plaintiff's expert medical witness.
Jones JW, McCullough LB, Richman BW.
Center for Health Policy and Medical Ethics, Baylor Medical College, Houston, TX 77030, USA.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Am J Orthod Dentofacial Orthop. 2004 Jul;126(1):131-2.
Litigation, legislation, and ethics. Res ipsa loquitor: the thing speaks for itself.
Jerrold L.
Dental School of Orthodontics, Jacksonville University, Jacksonville, FL, USA.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Br J Nurs. 2004 Jun 10;13(11):668
Nurse who compromised patient care through delegating a task.
Khaliullah K.
Surgical Skills Unit, Ninewells Hospital and Medical School, University of Dundee, Scotland, UK.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
Emerg Med Serv. 2004 Jun;33(6):122.
Drunk, doped up and on duty: what's a manager to do?
Erich J.
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
|