Medical Malpractice Claims and Mitigation Strategies Following Spine Surgery

Jackson, Keith L.; Rumley, Jacob; Griffith, Matthew; Linkous, Timothy R.; Agochukwu, Uzondu F.; DeVine, John G.

doi:10.1177/2192568220939524

Cited by 12 publications

(8 citation statements)

References 38 publications

(160 reference statements)

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“…Through professional commitment, the doctor is available to the patient with all his/her knowledge and abilities [ 22 ]. When the latter turns against the doctor—complaining if the result of the medical act does not coincide with their expectations—there is a risk that the doctor will develop a defense mechanism that no longer meets the standards of professionalism, triggering an imbalance between medical thinking and legal issues of the medical practice [ 22 , 32 ]. This creates the premises for defensive medical practice.…”

Section: Discussionmentioning

confidence: 99%

The Personal and Professional Impact of Patients’ Complaints on Doctors—A Qualitative Approach

Hanganu

Ioan

2022

IJERPH

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Background: Complaints regarding medical practice represent a harsh reality of the current world. Patients have the right to receive explanations and compensation when they are injured during the medical act, but the increased potential for exposure to complaints determines personal and professional consequences for the doctors, with significant impact on their health and practice. Thus, the aim of our research was to analyze in depth the impact of complaints on the doctors involved. Materials and methods: The authors conducted a qualitative study, using a semi-structured interview, addressed to doctors who had complaints from patients. The participants in our research were identified using an adapted version of the snowball method. Results: After the analysis of the interviews using the inductive method, nine themes resulted, seven of which are addressed in this paper: injustice, personal impact, professional impact, difficulties, supportive factors, the attitude of the hospital management and the attitude of colleagues. At the personal level, the doctors were overwhelmed by insomnia, nightmares, stress and anxiety, and at the professional level by doubts about medical decisions, fear, anxiety and the tendency to avoid patients with severe diseases. Conclusions: The study revealed that physicians who had complaints from patients are deeply affected by the complaint itself and the associated investigation procedure, even if, to a lesser extent, some of the participants found motivation for a better management of the situation. The study also showed the need for changes in the legal and medical systems in order to create mechanisms to support the doctors during the investigation process.

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Section: Discussionmentioning

confidence: 99%

The Personal and Professional Impact of Patients’ Complaints on Doctors—A Qualitative Approach

Hanganu

Ioan

2022

IJERPH

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“…NHS provision and the medicolegal climate are similar in NHS Scotland and England. Increased litigation in spine surgery is associated with an increase in defensive medicine in the USA with increased length of stay, investigation, and hospital charges [ 24 ]. Spinal conditions associated with litigation may be less prevalent in countries with lower rates of litigation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Demographics of Cauda Equina Syndrome: A Population-Based Incidence Study

et al. 2022

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Introduction Cauda Equina Syndrome (CES) has significant medical, social and legal consequences. Understanding the number of people presenting with CES and their demographic features is essential for planning healthcare services to ensure timely and appropriate management. We aimed to establish the incidence of CES in a single country and stratify incidence by age, gender, and socioeconomic status. As no consensus clinical definition of CES exists, we compared incidence using different diagnostic criteria. Methods All patients presenting with radiological compression of the cauda equina due to degenerative disc disease and clinical CES requiring emergency surgical decompression during a one-year period were identified at all centers performing emergency spinal surgery across Scotland. Initial patient identification occurred during the emergency hospital admission, and case ascertainment was checked using ICD-10 diagnostic coding. Clinical information was reviewed and incidence rates for all demographic and clinical groups were calculated. Results We identified 149 patients with CES in one year from a total population of 5.4 million, giving a crude incidence of 2.7 (95% CI: 2.3-3.2) per 100,000 per year. CES occurred more commonly in females and in the 30-49 year age range, with an incidence per year of 7.2 (95% CI 4.7-10.6) per 100,000 females age 30-39. There was no association between CES and socioeconomic status. CES requiring catheterisation had an incidence of 1.1 (95% CI: 0.8-1.5) per 100,000 adults per year. The use of ICD-10 codes alone to identify cases gave much higher incidence rates, but was inaccurate, with 55% (117/211) of patients with a new ICD-10 code for CES found not to have CES on clinical notes review. Conclusion CES occurred more commonly in females and in those between 30-49 years, and had no association with socioeconomic status. The incidence of CES in Scotland is at least four times higher than previous European estimates of 0.3-0.6 per 100,000 population per year. Incidence varies with clinical diagnostic criteria. To enable comparison of rates of CES across populations, we recommend using standardised clinical and radiological criteria and standardisation for population structure.

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“…24 Still this growing awareness may have led spine surgeons to adapt certain other practices to mitigate risk such as engaging in a more thorough informed consent process. 25 Despite medicolegal differences by jurisdiction, and even if the majority of cases against spine surgeons were successfully defended, the experience of litigation brings on monetary, time, and social stress that surgeons may have been trying to avoid through practice adaptations where possible. Spine surgery safety may have improved in this time.…”

Section: Discussionmentioning

confidence: 99%