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Medicolegal Issues: The Pitfalls and Pratfalls of the Bariatric Surgery Practice

  • Kathleen M. McCauley

Abstract

With extraordinary gains in medical technology comes the increase in medical malpractice litigation. In no area of medicine has the increase in both been more evident than in the surgical management of obesity. The increase in litigation involving bariatric surgery has been attributed to several factors, including an increase in the number of bariatric procedures performed generally (1), inexperience of the operator (2), the inherent risk of these complicated surgical procedures, and the complex nature of the patient population. The consequences of this quantum leap include negative impacts on the cost of professional liability insurance (3,4), the physician credentialing process, and the regulation and discipline of licensed health care practitioners nationwide.

Keywords

Bariatric Surgery Obesity Surgery Bariatric Surgeon Informed Consent Process Medical Malpractice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References and Notes

  1. 1.
    Mathias JM. Increase in bariatric surgery brings a surge in legal cases. OR Manager 2002;18(2).Google Scholar
  2. 2.
    Kowalczyk L. Gastric bypass risk is linked to inexperience. Boston Globe 2004, January 4.Google Scholar
  3. 3.
    Alt SJ. Market memo: liability insurance premiums on bariatric surgery soar. Health Care Strategic Manag 2004;22(1):1.Google Scholar
  4. 4.
    Rice B. How high now? Med Econ 2004;81:57–59.Google Scholar
  5. 5.
    Twiddy D. Associated Press 2004, August 26.Google Scholar
  6. 6.
    For a more extensive discussion about the current medical malpractice crisis in the United States, see Studdert DM, Mello MM, Brennan TA, Medical malpractice. N Engl J Med 2003;348(23):2281, corrected in N Engl J Med 2003; 349(10):1010; and Mello MM, Studdert DM, Brennan TA. The new medical malpractice crisis. N Engl J Med 2004; 350(3):283.Google Scholar
  7. 7.
    Mohr JC. American medical malpractice litigation in historical perspective, JAMA 2000;283(13):1731.CrossRefPubMedGoogle Scholar
  8. 8.
    Ibid., p. 1732.CrossRefGoogle Scholar
  9. 9.
    Ibid., citing Mohr JC. Doctors and the Law: Medical Jurisprudence in Nineteenth-Century America. New York: Oxford University Press, 1993.CrossRefGoogle Scholar
  10. 10.
  11. 11.
  12. 12.
  13. 13.
  14. 14.
    Ibid., p. 1734.CrossRefGoogle Scholar
  15. 15.
    Ibid., p. 1734.CrossRefGoogle Scholar
  16. 16.
    Ibid., p. 1735.CrossRefGoogle Scholar
  17. 17.
    Ibid., p. 1735.CrossRefGoogle Scholar
  18. 18.
    Miller D. Liability for medical malpractice: issues and evidence. Joint Economic Committee, U.S. Congress, Vice Chair Jim Saxton (R-NJ), May 2003 (www.house.gov), accessed September 6, 2004.Google Scholar
  19. 19.
    Black’s Law Dictionary, citing Mathews v. Walker, 34 Ohio App.2d 128, 296 N.E.ed 569, 571.Google Scholar
  20. 20.
    Mohr JC. American medical malpractice litigation in historical perspective. JAMA 2000;283(13):1731, citing Blackstone W. Commentaries on the Laws of England, vol 3. Oxford, England: Clarendon Press, 1768:122.CrossRefPubMedGoogle Scholar
  21. 21.
    See, generally, Fiscina S, et al. Medical Liability. Eagan, MN: West Group, 2004:209. West Publishing, 1991.Google Scholar
  22. 24.
    Misreading Obesity Surgery Risk, www.rmf.harvard.edu, accessed August 7, 2004.Google Scholar
  23. 25.
    Furrow BR, et al. Bioethics: Health Care Law and Ethics, 3rd ed. St. Paul, MN.Google Scholar
  24. 26.
    Pub. L. No. 104-191,110 Stat. 1936 (1996) (codified in portions of 29 U.S.C., 42 U.S.C., and 18 U.S.C.).Google Scholar
  25. 27.
  26. 28.
  27. 29.
    For a more comprehensive discussion of the administrative simplification process, see Perrow et al. The Health Insurance Portability and Accountability Act: An Overview of Administrative Simplification, XIV J. Civ. L. 231 (2002).Google Scholar
  28. 30.
    42 U.S.C. § 1320d et seq (2002).Google Scholar
  29. 31.
    Standards for Privacy of Individually Identifiable Health Information. 65 Fed. Reg. 82462 (December 28, 2000).Google Scholar
  30. 32.
    Standards for Privacy of Individually Identifiable Health Information. 45 C.F.R. § 164.502 (2001).Google Scholar
  31. 33.
    Standards for Privacy of Individually Identifiable Health Information. 67 Fed. Reg. 53181 (August 14, 2002).Google Scholar
  32. 34.
    42 U.S.C. § 1320d–3 (2002). Small health plans must have complied by April 14, 2004. Ibid.Google Scholar
  33. 35.
    45 C.F.R. § 164.501 (2001).Google Scholar
  34. 36.
  35. 37.
  36. 38.
  37. 39.
    45 C.F.R. § 164.502 (2001).Google Scholar
  38. 40.
  39. 41.
    45 C.F.R. § 164.506.Google Scholar
  40. 42.
    45 C.F.R. § 164.508 (2001).Google Scholar
  41. 43.
    45 C.F.R. § 164.Google Scholar
  42. 44.
  43. 45.
    45 C.F. R. § 164.512 (2001).Google Scholar
  44. 46.
    45 C.F.R. § 164.522 (2001).Google Scholar
  45. 47.
    45 C.F.R. § 164.524 (2001).Google Scholar
  46. 48.
    45 C.F.R. § 164.526 (2001).Google Scholar
  47. 49.
    45 C.F.R § 164.520 (2001).Google Scholar
  48. 50.
    45 C.F.R. § 164.528 (2001).Google Scholar
  49. 51.
    42 U.S.C. § 1320d-7 (2002). “Contrary to state law” is defined as impossible to comport with both state and federal law or that the state law is a major obstacle to the implementation to the Privacy Rule. 45 C.F.R. § 160.203 (2001).Google Scholar
  50. 52.
    45 C.F.R. § 160.203(a) (2001).Google Scholar
  51. 53.
  52. 54.
    Guidelines for Granting Privileges in Bariatric Surgery, www.asbs.org/html/guidelines.html, accessed September 1, 2004.Google Scholar
  53. 55.
    Zimmerman R. Doctors’ new tool to fight lawsuits: saying “I’m sorry.” The Wall Street Journal 2004, May 18.Google Scholar
  54. 56.
    Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel, RM. Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA 1997;277:553–559.CrossRefPubMedGoogle Scholar
  55. 57.
    Ambady N, LaPlante D, Nguyen T, Rosenthal R, Chaumeton N, Levinson W. Surgeon’s tone of voice: a clue to malpractice history. Surgery 2002;132:5–9.CrossRefPubMedGoogle Scholar
  56. 58.
    Bariatric Surgery: American College of Surgeons Recommendations for Facilities Performing Bariatric Surgery. Bull Am Coll Surg 2000;85(9).Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Kathleen M. McCauley
    • 1
  1. 1.Department of Medical Litigation, Goodman, Allen, and FilettiGlen AllenUSA

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