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Periprocedural Iatrogenic Injuries and Death in Emergency and Trauma Surgery: A Forensic Perspective

  • Antonio Osculati
  • Silvia D. Visonà
  • Matteo Moretti
Chapter

Abstract

The chapter presents a forensic perspective about the acute care and emergency surgery medical activity. The first part of the present chapter focuses on the widely discussed issue of medical liability in the peculiar setting of emergency and trauma surgery. Firstly, the authors present some significant international data about claims and suits against physicians, in order to provide an overview of the current worldwide situation.

Then, the extreme importance of proper medical documentation in the emergency setting (medical chart, informed consent document, emergency room assistance sheet, nursing documentation) is discussed.

The problem of professional standard is also addressed. Concerning guidelines, even though their use is not compulsory for the clinician, they are of special relevance during trials concerning medical liability, as they are often used by experts that take part to lawsuits and they are also expressly addressed by the members of the Court.

Finally, the controversial issue of the informed consent in emergency care is faced.

References

  1. 1.
    Waxman DA, Greenberg MD, Ridgely MS, Kellermann AL, Heaton P. The effect of malpractice reform on emergency department care. N Engl J Med. 2014;371:1518–25.CrossRefGoogle Scholar
  2. 2.
    Massachusetts Medical Society. Investigation of defensive medicine in massachusetts. Informational Report: I-08 – 02. http://www.massmed.org/defensivemedicine/.
  3. 3.
    Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365:629–36.CrossRefGoogle Scholar
  4. 4.
    Brown TW, McCarthy ML, Kelen GD, Levy F. An epidemiologic study of closed emergency department malpractice claims in a national database of physician malpractice insurers. Acad Emerg Med. 2010;17:553–60.CrossRefGoogle Scholar
  5. 5.
    Szalados JE. Legal issues in the practice of critical care medicine: a practical approach. Crit Care Med. 2007;35:S44–58.CrossRefGoogle Scholar
  6. 6.
    Satyanarayana Rao KH. Informed consent: an ethical obligation or legal compulsion? J Cutan Aesthet Surg. 2008;1:33–5.CrossRefGoogle Scholar
  7. 7.
    Dorney MS. Moore v. The Regents of the University of California: balancing the need for biotechnology innovation against the right of informed consent. Berkeley Technol Law J. 1990;5:333.Google Scholar
  8. 8.
    Ferrara SD. Medical malpractice and legal medicine. Int J Legal Med. 2013;127:541–3.CrossRefGoogle Scholar
  9. 9.
    Stewart RM, Corneille MG, Johnston J, Geoghegan K, Myers JG, Dent DL, et al. Transparent and open discussion of errors does not increase malpractice risk in trauma patients. Ann Surg. 2006;243:645–9, discussion 649–51.CrossRefGoogle Scholar
  10. 10.
    Pandit MS, Pandit S. Medical negligence: coverage of the profession, duties, ethics, case law, and enlightened defense—a legal perspective. Indian J Urol. 2009;25:372–8.CrossRefGoogle Scholar
  11. 11.
    Madea B. Handbook of forensic medicine. Hoboken: Wiley; 2014.CrossRefGoogle Scholar
  12. 12.
    Ebben RHA, Vloet LCM, Verhofstad MHJ, Meijer S, Mintjes-de Groot JAJ, van Achterberg T. Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review. Scand J Trauma Resusc Emerg Med. 2013;21:9.CrossRefGoogle Scholar
  13. 13.
    Hartman KM, Liang JDBA. Exceptions to informed consent in emergency medicine. Hosp Physician. 1999. http://www.turner-white.com/pdf/hp_mar99_emergmed.pdf.
  14. 14.
    Testini M, Girardi A, Isernia RM, De Palma A, Catalano G, Pezzolla A, Gurrado A. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 2017;12:23.  https://doi.org/10.1186/s13017-017-0134-5.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Antonio Osculati
    • 1
  • Silvia D. Visonà
    • 1
  • Matteo Moretti
    • 1
  1. 1.Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly

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