Litigation in Anesthesia and Intensive Care Units: An Italian Retrospective Study

Abstract

Anesthesiologists consider professional insurance and its medico-legal problems as a remarkable aspect of their job. “Associazione Anestesisti Rianimatori Ospedalieri Italiani—Emergenza ed Area Critica” (AAROI-EMAC) is the Italian professional association of anesthesiologists and intensivists that works to train its subscribers on safety measures. This is a retrospective observational study on an insurance complaints database for anesthetic accidents that result in injuries to patients. The analyzed period runs from 1 January 2014 to 31 December 2016. A total of 1309 complaints related to 873 insurance claims were analyzed. Criminal complaints comprised 805 (64.4%) of the total, and civil complaints were 445 (35.6%). The iatrogenic damage claimed included: death (58% of the cases); peripheral nerve damage (8%); spinal cord injuries (5%); unspecified injuries (7%); dental damage (4%); infections (3%); needing second surgical procedure (2%); and other injuries (13%). There is a statistical significance between the size of the hospital and the number of the claims: small hospital complaints comprised 40.1% of the cases, while complaints against medium-sized and large hospitals constituted 20.6% of the cases (χ2GL = 8 = 39.87, p = 0.00). In Italy, anesthesiologists and intensivists are often involved in litigation even when they are not directly responsible for iatrogenic injuries, and the most frequent claims in ICU are related post-operative complications.

Analysis on Burnout, Job Conditions, Alexithymia, and Other Psychological Symptoms in a Sample of Italian Anesthesiologists and Intensivists, Assessed Just before the COVID-19 Pandemic: An AAROI-EMAC Study

“…All physicians included in our sample had to be a member of the anesthesia association AAROI-EMAC (Italian Association of Hospital Anesthesiologists, Pain Medicine Specialists, Critical Care and Emergency Physicians), which has around 10,000 subscribers, and actively practicing [ 17 ]. The sample was collected via a questionnaire that was administered in the presence of all those who attended refresher courses at the AAROI-EMAC simulation center in February 2020 ( Figure 1 ).…”

Strengths and Weaknesses of Cancer Pain Management in Italy: Findings from a Nationwide SIAARTI Survey

“…Unfortunately, the precise number of Italian anesthesiologists is not available. Since previous investigations highlighted that in Italy there are about 20,500 anesthesiologists and intensive care unit physicians [ 29 ], the target population corresponds to about half of the Italian anesthetists. Although it represents an important selection bias, for the purposes of the survey, this sample appears to be representative.…”

Open Issues and Practical Suggestions for Telemedicine in Chronic Pain

“…Specifically, all local requirements for healthcare must be fulfilled by remote systems, as well as by traditional in-presence organizations, and some technical solutions must be found to this aim. Therefore, first of all, knowledge of regulation is needed so that medico-legal problems are detected and addressed, and then rules must be adapted to remote systems [ 29 ]. The main legal issues to be faced are related to data protection, privacy, and delivery of reports and prescriptions.…”