Abstract
Despite the fact that physicians seek to provide excellent clinical care for their patients, issues of medical malpractice may arise for even the most conscientious and well-trained physician. Urologists face an 11% annual risk of being involved in a malpractice claim, with about 3% of urologists per year facing a claim that results in a payment to a plaintiff. As such, it is important for urologists to be informed about medical malpractice. This chapter seeks to inform urologists about the medical malpractice system in the United States, provide data about malpractice claims in urology, educate readers about the malpractice claim process, and review strategies for preventing malpractice claims, as well as provide an overview on malpractice insurance and tort reform. In addition, we discuss medicolegal considerations in new surgical technology and techniques, as well as inform urologists about ethical considerations that they should be knowledgeable about in their practice, such as the principles of medical ethics, informed consent, conflicts of interest, expert witness testimony, and in-office ancillary procedures.
References
Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139.
Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629–36.
Singh H. National Practitioner Data Bank (2014): Adverse Action and Medical Malpractice Reports (1990–2014) [Internet]. 2014. Available from: https://www.npdb.hrsa.gov/analysistool
Gower J. 2015 medical malpractice payout analysis [Internet]. www.diederichhealthcare.com. 2015 [cited 2016 Aug 30]. Available from: http://www.diederichhealthcare.com/the-standard/2015-medical-malpractice-payout-analysis/
Kaplan GW. Malpractice risks for urologists. Urology. 1998;51(2):183–5.
Sobel DL, Loughlin KR, Coogan CL. Medical malpractice liability in clinical urology: a survey of practicing urologists. J Urol. 2006;175(5):1847–51.
Hsieh MH, Tan AG, Meng MV. Medical malpractice in American urology: 22-year national review of the impact of caps and implications for contemporary practice. J Urol. 2008;179(5):1944–9. –discussion1949.
Sherer BA, Coogan CL. The current state of medical malpractice in urology. Urology. 2015;86(1):2–9.
Perrotti M, Badger W, Prader S, Moran ME. Medical malpractice in urology, 1985 to 2004: 469 consecutive cases closed with indemnity payment. J Urol. 2006;176(5):2154–7. –discussion2157.
Benson JS, Coogan CL. Urological malpractice: analysis of indemnity and claim data from 1985 to 2007. J Urol. 2010;184(3.) 1086–90–quiz1235
Sherer BA, Boydston KC, Coogan CL. Urological malpractice: claim trend analysis and severity of injury. Urol Pract. 2016;3:1–6.
Knoll AM. The role of private counsel in medical malpractice cases. Med Econ. 2016;93(11):58–60.
Floyd TK. Medical malpractice: trends in litigation. Gastroenterology. 2008;134(7.) 1822–5–1825.e1
Feld AD, Moses RE. Most doctors win: what to do if sued for medical malpractice. Am J Gastroenterol. 2009;104(6):1346–51.
Liebman CB, Hyman CS. A mediation skills model to manage disclosure of errors and adverse events to patients. Health Aff (Millwood). 2004;23(4):22–32.
Hickson GB, Clayton EW, Githens PB, Sloan FA. Factors that prompted families to file medical malpractice claims following perinatal injuries. JAMA. 1992;267(10):1359–63.
Vincent C, Young M, Phillips A. Why do people sue doctors? A study of patients and relatives taking legal action. Lancet. 1994;343(8913):1609–13.
Renkema E, Broekhuis M, Ahaus K. Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety. BMC Health Serv Res. 2014;14:38.
Lichtstein DM, Materson BJ, Spicer DW. Reducing the risk of malpractice claims. Hosp Pract (1995). 1999;34(7.) 69–72–75–6–79
Volpintesta E. The threat of malpractice suits. Health Aff (Millwood). 2013;32(11):2058.
Commission TJ. Hospital accreditation standards. Oakbrook Terrace: Joint Commission Resources; 2007.
Clinton HR, Obama B. Making patient safety the centerpiece of medical liability reform. N Engl J Med. 2006;354(21):2205–8.
Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med. 2007;356(26):2713–9.
Kraman SS, Hamm G. Risk management: extreme honesty may be the best policy. Ann Intern Med. 1999;131(12):963–7.
O’leary MP, Baum NH, Bohnert WW, Blizzard R, Bonney WW, Cooper TP, et al. 2003 American Urological Association Gallup survey: physician practice patterns, cryosurgery/brachytherapy, male infertility, female urology and insurance/professional liability. J Urol. 2004;171(6 Pt 1):2363–5.
Mello MM, Chandra A, Gawande AA, Studdert DM. National costs of the medical liability system. Health Aff (Millwood). 2010;29(9):1569–77.
Studdert DM, Mello MM, Brennan TA. Medical malpractice. N Engl J Med. 2004;350(3):283–92.
Konety BR, Dhawan V, Allareddy V, Joslyn SA. Impact of malpractice caps on use and outcomes of radical cystectomy for bladder cancer: data from the surveillance, epidemiology, and end results program. J Urol. 2005;173(6):2085–9.
Kass JS, Rose RV. Medical malpractice reform–historical approaches, alternative models, and communication and resolution programs. AMA J Ethics. 2016;18(3):299–310.
Cooper JD, Clayman RV, Krummel TM, Schauer PR, Thompson C, Moreno JD. Inside the operating room–balancing the risks and benefits of new surgical procedures: a collection of perspectives and panel discussion. Cleve Clin J Med. 2008;75 Suppl 6:S37–48–discussionS49–54.
Hampson LA, Brajtbord JS, Meng MV. The future of quality in urologic oncology: evaluating the horizon of surgical standards. Urol Oncol. 2014;32(6):735–40.
Hofer MD, Meeks JJ, Cashy J, Kundu S, Zhao LC. Impact of increasing prevalence of minimally invasive prostatectomy on open prostatectomy observed in the national inpatient sample and national surgical quality improvement program. J Endourol. 2013;27(1):102–7.
Colaco M, Sandberg J, Badlani G. Influencing factors leading to malpractice litigation in radical prostatectomy. J Urol. 2014;191(6):1770–5.
Schroeck FR, Krupski TL, Sun L, Albala DM, Price MM, Polascik TJ, et al. Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy. Eur Urol. 2008;54(4):785–93.
Rogers SO, Gawande AA, Kwaan M, Puopolo AL, Yoon C, Brennan TA, et al. Analysis of surgical errors in closed malpractice claims at 4 liability insurers. Surgery. 2006;140(1):25–33.
Liberman D, Trinh Q-D, Jeldres C, Valiquette L, Zorn KC. Training and outcome monitoring in robotic urologic surgery. Nat Rev Urol. 2012;9(1):17–22.
Lee JY, Mucksavage P, Sundaram CP, McDougall EM. Best practices for robotic surgery training and credentialing. J Urol. 2011;185(4):1191–7.
Livingston EH, Harwell JD. The medicolegal aspects of proctoring. Am J Surg. 2002;184(1):26–30.
Rashid HH, Leung Y-YM, Rashid MJ, Oleyourryk G, Valvo JR, Eichel L. Robotic surgical education: a systematic approach to training urology residents to perform robotic-assisted laparoscopic radical prostatectomy. Urology. 2006;68(1):75–9.
Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody JO, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol. 2002;168(3):945–9.
Ahlering TE, Skarecky D, Lee D, Clayman RV. Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol. 2003;170(5):1738–41.
Patel VR, Tully AS, Holmes R, Lindsay J. Robotic radical prostatectomy in the community setting – the learning curve and beyond: initial 200 cases. J Urol. 2005;174(1):269–72.
Minimally Invasive Mini-Fellowship Program [Internet]. University of California, Irvine; [cited 2016 Aug 30]. Available from: http://www.urology.uci.edu/education_resources.shtml
Delineation of Privelages for Laparoscopic Urological Procedures [Internet]. 2011 ed. American Urological Association; [cited 2016 Aug 30]. Available from: http://www.auanet.org/education/policy-statements/laparoscopic-urological-procedures.cfm
Zorn KC, Gautam G, Shalhav AL, Clayman RV, Ahlering TE, Albala DM, et al. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons. J Urol. 2009;182(3):1126–32.
Urologic Robotic Surgery Online Course [Internet]. American Urological Association; [cited 2016 Aug 30]. Available from: https://www.auanet.org/university/modules/module-courseInfo.cfm?id=428
Association AU. Standard Operating Practices (SOP’S) for Urologic Robotic Surgery [Internet]. 2014. Available from: http://www.auanet.org/common/pdf/about/SOP-Urologic-Robotic-Surgery.pdf
Association AM. Principles of medical ethics [Internet]. 2001st ed. Available from: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/principles-medical-ethics.page
Schloenhoff v Society of New York Hospital 211 NY125. New York; 1914.
Natanson v Kline: 186 Kan. 393, 350 P. 2d 1093. United States Court of Appeals; 1960.
Canterbury v Spence: 464 F.2d 772. District of Columbia; 1972.
Jones B. Legal aspects of consent. BJU Int. 2000;86(3):275–9.
Statements on Principles [Internet]. 12 ed. American College of Surgeons; [cited 2016 Aug 30]. Available from: https://www.facs.org/about-acs/statements/stonprin#anchor171960
Hampson LA, Montie JE. Conflict of interest in urology. J Urol. 2012;187(6):1971–7.
Association AU. AUA disclosure policy [Internet]. 2016 ed. 2016 Feb. Available from: http://www.auanet.org/education/aua-disclosure-policy.cfm
American Urological Assocation, editor. Guiding principles for membership interactions with industry [Internet]. 2010 ed. [cited 2016 Aug 30]. Available from: http://www.auanet.org/education/policy-statements/membership-interactions-with-industry.cfm
Association AU. Expert witness testimony in medical liability cases [Internet]. 2016 ed. 2016 May. Available from: http://www.auanet.org/education/policy-statements/testimony-in-medical-liability-cases.cfm
Sunaryo PL, Svider PF, Jackson-Rosario I, Eloy JA. Expert witness testimony in urology malpractice litigation. Urology. 2014;83(4):704–8.
Mitchell JM. The prevalence of physician self-referral arrangements after Stark II: evidence from advanced diagnostic imaging. Health Aff. 2007;26(3):w415–24.
Hillman BJ, Goldsmith J. Imaging: the self-referral boom and the ongoing search for effective policies to contain it. Health Aff. 2010;29(12):2231–6.
Office USG. Medicare: higher use of advanced imaging services by providers who self-refer costing medicare millions [Internet]. United States Government Accountability Office; 2012 Nov p. 54. Available from: http://books.google.com/books?id=LvpQkgEACAAJ&dq=higher+use+of+advanced+imaging+services+by+providers+who+self+refer&hl=&cd=4&source=gbs_api
Romano DH. Self-referral of imaging and increased utilization: some practical perspectives on tackling the dilemma. J Am Coll Radiol. 2009;6(11):773–9.
Schneider JE, Ohsfeldt RL, Scheibling CM, Jeffers SA. Organizational boundaries of medical practice: the case of physician ownership of ancillary services. Health Econ Rev. 2012;2(1):7.
Association AU. AUA in-office ancillary services guiding principles [Internet]. 2013 ed. Available from: http://www.auanet.org/about/policy-statements/ancillary-guiding-principles.cfm
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Hampson, L.A., Meng, M.V. (2018). Ethical and Medicolegal Considerations. In: Sotelo, R., Arriaga, J., Aron, M. (eds) Complications in Robotic Urologic Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-62277-4_8
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