Medical certificate, post-mortem examination or certificate guarantee their authenticity of the content through the article 233 of the criminal act. The article 233 of the criminal act states that if a medical or oriental medical doctor, dentist or midwife prepare false medical certificate, postmortem examination or certificate life or death, one shall be punished. To constitute the crime of issuance of falsified medical certificates, it is necessary for the contents of the certificate to be substantially contrary to the truth, as well as it is needed the subjective perception that the contents of the certificate are false. On the article 17 of the medical service act, no one may prepare a medical certificate, a report or certificate of postmortem examination to a patient or public prosecutor in a district public prosecutors' office, who conducts a medical service and has given the medical treatment or conducted the postmortem examination by him/herself: Provided that, such certificate or report may be issued for a patient without giving any medical treatment, if the patient has died within 48 hours after his/her last medical treatment, while if the medical doctor, dentist or oriental medical doctors who examined a patient or conducted a postmortem examination of the dead patient is unable to issue such certificate or report due to an inevitable cause or event, any other medical doctor, dentist or oriental medical doctor who works for the same medical institution, may issue such certificate or report based on the medical records of the patient.
Autopsy ; Crime ; Criminals ; Dentists ; Humans ; Liability, Legal* ; Medical Records ; Midwifery ; Physicians ; Social Responsibility*

BACKGROUND: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. MATERIAL AND METHOD: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. RESULT: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. CONCLUSION: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.
Cause of Death ; CD-ROM ; Hemopneumothorax* ; Hemothorax ; Humans ; Informed Consent ; Jurisprudence ; Malpractice ; Pneumothorax ; Retrospective Studies ; Supreme Court Decisions

Objectives: Assessing medical disputes requires both medical and legal expertise, presenting challenges for patients seeking clarity regarding potential malpractice claims. This study aimed to develop and evaluate a chatbot based on a chain-of-thought pipeline using a large language model (LLM) for providing medical dispute counseling and compare its performance with responses from human experts. Methods: Retrospective counseling cases (n = 279) were collected from the Korea Medical Dispute Mediation and Arbitration Agency’s website, from which 50 cases were randomly selected as a validation dataset. The Claude 3.5 Sonnet model processed each counseling request through a five-step chain-of-thought pipeline. Thirty-eight experts evaluated the chatbot’s responses against the original human expert responses, rating them across four dimensions on a 5-point Likert scale. Statistical analyses were conducted using Wilcoxon signed-rank tests. Results: The chatbot significantly outperformed human experts in quality of information (p < 0.001), understanding and reasoning (p < 0.001), and overall satisfaction (p < 0.001). It also demonstrated a stronger tendency to produce opinion-driven content (p < 0.001). Despite generally high scores, evaluators noted specific instances where the chatbot encountered difficulties. Conclusions A chain-of-thought–based LLM chatbot shows promise for enhancing the quality of medical dispute counseling, outperforming human experts across key evaluation metrics. Future research should address inaccuracies resulting from legal and contextual variability, investigate patient acceptance, and further refine the chatbot’s performance in domain-specific applications.

Objectives: Assessing medical disputes requires both medical and legal expertise, presenting challenges for patients seeking clarity regarding potential malpractice claims. This study aimed to develop and evaluate a chatbot based on a chain-of-thought pipeline using a large language model (LLM) for providing medical dispute counseling and compare its performance with responses from human experts. Methods: Retrospective counseling cases (n = 279) were collected from the Korea Medical Dispute Mediation and Arbitration Agency’s website, from which 50 cases were randomly selected as a validation dataset. The Claude 3.5 Sonnet model processed each counseling request through a five-step chain-of-thought pipeline. Thirty-eight experts evaluated the chatbot’s responses against the original human expert responses, rating them across four dimensions on a 5-point Likert scale. Statistical analyses were conducted using Wilcoxon signed-rank tests. Results: The chatbot significantly outperformed human experts in quality of information (p < 0.001), understanding and reasoning (p < 0.001), and overall satisfaction (p < 0.001). It also demonstrated a stronger tendency to produce opinion-driven content (p < 0.001). Despite generally high scores, evaluators noted specific instances where the chatbot encountered difficulties. Conclusions A chain-of-thought–based LLM chatbot shows promise for enhancing the quality of medical dispute counseling, outperforming human experts across key evaluation metrics. Future research should address inaccuracies resulting from legal and contextual variability, investigate patient acceptance, and further refine the chatbot’s performance in domain-specific applications.

Objectives: Assessing medical disputes requires both medical and legal expertise, presenting challenges for patients seeking clarity regarding potential malpractice claims. This study aimed to develop and evaluate a chatbot based on a chain-of-thought pipeline using a large language model (LLM) for providing medical dispute counseling and compare its performance with responses from human experts. Methods: Retrospective counseling cases (n = 279) were collected from the Korea Medical Dispute Mediation and Arbitration Agency’s website, from which 50 cases were randomly selected as a validation dataset. The Claude 3.5 Sonnet model processed each counseling request through a five-step chain-of-thought pipeline. Thirty-eight experts evaluated the chatbot’s responses against the original human expert responses, rating them across four dimensions on a 5-point Likert scale. Statistical analyses were conducted using Wilcoxon signed-rank tests. Results: The chatbot significantly outperformed human experts in quality of information (p < 0.001), understanding and reasoning (p < 0.001), and overall satisfaction (p < 0.001). It also demonstrated a stronger tendency to produce opinion-driven content (p < 0.001). Despite generally high scores, evaluators noted specific instances where the chatbot encountered difficulties. Conclusions A chain-of-thought–based LLM chatbot shows promise for enhancing the quality of medical dispute counseling, outperforming human experts across key evaluation metrics. Future research should address inaccuracies resulting from legal and contextual variability, investigate patient acceptance, and further refine the chatbot’s performance in domain-specific applications.

Mostly of the sudden deaths, except in-hospital death and death within 48 hours of discharge, are declared in the emergency department by emergency physician. The purpose of this study is to review the protocol of cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest by understanding the cause of sudden death from autopsy results. A retrospective analysis was performed by 48 months of medical records from emergency department of a tertiary hospital. The analysis was made from the patient group which gone through autopsy in the main office of National Institute of Scientific Investigation. In the emergency department, 1913 patients were declared death and 43 patients have received autopsy and 19 (1.0%) were natural death. 14 partients received CPR in the natural death group, and 13 were specified as cardiovascular disease. Result of this study represents the importance of prehospital CPR in case of unexpected cardiac arrest patients. However to generalize this result, all dead patients must go through autopsies for medical purpose which the frequency alse should be increased.
Autopsy ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Death, Sudden ; Emergencies ; Heart Arrest ; Humans ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND: We describe the characteristics of malpractice claims related to central venous catheterization and identify causes and potential preventability of such claims. METHODS: A retrospective study was performed by reviewing records at Lawnb and Lx CD-rom. The records on closed malpractice claim related to central venous catheterization were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the factors associated with a successful defense. RESULTS: Twelve closed claim cases, related to central venous cathetertization were reviewed in the data for malpractice. Catheter-related complications were pneumothorax, hemothorax, cardiac tamponade, pyothorax, hematoma due to arterial puncture, pseudoaneurysm. Almost cases resulted in indemnity payment and verdict for patient. CONCLUSIONS: Although malpractice claims related to central venous catheterization were uncommon, they resulted in high rate and amount of indemnity payments. In pediatric patient, catheterization should be performed with attention. Clinicians should consider the underlying disease of patients and do any pretreatment if needed. Post-procedural radiologic confirmation can improve patient outcome and is also associated with decreased indemnity risk. Informed consent is also important.
Aneurysm, False ; Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous* ; Catheters ; CD-ROM ; Central Venous Catheters* ; Empyema, Pleural ; Hematoma ; Hemothorax ; Humans ; Informed Consent ; Malpractice ; Pneumothorax ; Punctures ; Retrospective Studies

PURPOSE: We wanted to describe the characteristics of the malpractice claims related to acute appendicitis and to identify medico-legal problems and potential preventability of such claims. METHODS: A retrospective study was performed by reviewing the records at websites that furnishes judicial precedents. The records on closed malpractice claims involving acute appendicitis were abstracted from the files that were available for analysis. The records were reviewed and analyzed to determine the causes of the lawsuits, the pre- and post-operative diagnoses, the comorbid conditions of the patient, the causes of death or post-operative complications, the results of the lawsuits and the factors associated with a successful defense. RESULTS: Twelve closed claims involving acute appendicitis were founded in the malpractice data. Two claims were Supreme Court decisions and ten were district court decisions. The causes of lawsuit were categorized as follows: delay in diagnosis or operation, mistakes during operation, inappropriate management of postoperative complications and problems related to general anesthesia. 3 claims were assigned to each of the 4 particular causes of lawsuits. The most common causes of death were abscess with peritonitis and sepsis, and ten of which resulted in indemnity payments. CONCLUSION: Appropriate explanation and attention in the diagnosis/progress of appendicitis, getting an informed consent from the patient, the patients' comorbid conditions, early decision making in diagnosis/operation and proper care in the operation were critical for preventing lawsuits related to acute appendicitis.
Abscess ; Anesthesia, General ; Appendicitis* ; Cause of Death ; Decision Making ; Diagnosis ; Humans ; Informed Consent ; Jurisprudence ; Malpractice ; Peritonitis ; Postoperative Complications ; Retrospective Studies ; Sepsis ; Supreme Court Decisions

Objectives: With the recent global mpox outbreak, the JYNNEOS vaccine (Modified VacciniaAnkara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initiallyfavored for mpox immunization. Vaccine-associated side effects contribute to vaccinehesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events. Methods: Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information aboutspecific adverse events, including both local and systemic reactions, was collected. Results: The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site. Conclusion The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccineadministration techniques and the vaccine’s effects on broader demographics.

In June 2022, the first monkeypox case was reported as imported into Korea. The general public asked whether they should get vaccinated against monkeypox because of the recent COVID-19 vaccination experience. As of the current monkeypox outbreak situation, a ring vaccination strategy for the high-risk group is more appropriate than the mass population vaccination with smallpox vaccines. Therefore, identifying the proper target group by available vaccines based on the risk and benefit analysis is a key issue of the vaccination program. In addition, the target group should be reviewed by the epidemiological situation of the jurisdiction along with the updated evidence of the monkeypox virus on transmission dynamics, severity, and fatality.