Medicolegal implications from litigations involving necrotizing fasciitis

Abstract

Necrotizing fasciitis (NF) is one of the most severe healthcare-associated infections. Early diagnosis of NF is difficult because of nonspecific signs and symptoms in the early stage. NF often presents with risks of medicolegal disputes. This study aimed to provide baseline data on the general characteristics of medical accidents involving NF, features of NF, and typical court opinions regarding medical malpractice in Korea. Methods: In this study, 25 cases of medical malpractice litigation involving NF sentenced between 1998 and 2018 were analyzed with respect to 3 variables: medical accident, NF, and breach of duty. Results: The department of colorectal surgery was most frequently involved in litigation cases (40.0%), and colorectal surgery was the most frequent procedure before the diagnosis of NF (40.0%). The most common sites were the upper and lower extremities. The courts agreed that there was typically improper monitoring after treatment, frequently related to NF. Conclusion: These litigation cases imply that physicians cannot be blamed for the failure to prevent NF. The timely recognition and management of NF might be considered as one of the main factors for deciding malpractice in court. Therefore, surgeons, especially in the department of colorectal surgery, should pay attention to changes in the patient's status after surgery. Surgeons need to learn from medical accidents, as it is important for risk management, preventing the occurrence of similar cases, and improving the quality of healthcare services. We report the medicolegal implications from medical lawsuits involving NF.

Necrotizing Fasciitis of the Thigh as Unusual Colonoscopic Polypectomy Complication: Review of the Literature with Case Presentation

“…Indeed, NF misdiagnosis or mistreatment can promote medical malpractice litigation and lawsuits claiming compensation for patient damage. Several reasons may act as limitation of medical liability, such as patient-related (a medical history that could confer a risk of infection), healthcare-professionals-related (no-harm medical practice), and diseases-related factors (rapid progression and poor prognosis of NF) [29]. However, regardless of the outcome for the patient, timely recognition and management of NF seem to be some of the main factors for avoiding medical lawsuits and deciding malpractice in court [29].…”

Characteristics of Nursing-related Patient Safety Incidents and Qualitative Content Analysis: Secondary data Analysis of Medical Litigation Judgment (2014~ 2018)

“…간호 관련 환자안전사건의 일반적 특성을 파악하기 위해 의료소송 판결문을 분석한 선행연구와 환자안전보고학습 시스템의 분류 방법에 따라 사건 해결 기간 [21], 사건 발생 의료기관 유형 [22], 환자에게 발생한 위해 정도 [3], 환자안 전사건 유형 [3,23]을 계량적 분석 변수로 구성하였다. 간 호 관련 특성을 파악하기 위한 분석 변수는 사건 발생 간호 부서 [3], 사건 발생 교대근무 시간 [24], 관련 간호행위 [17],…”