BACKGROUND: The active involvement of anesthesiologists in chronic pain management has been associated with an increase in the number of related medical dispute cases. METHODS: Using the Korean Society of Anesthesiologists Legislation Committee database covering case files from July 2009 to June 2016, we explored injuries and liability characteristics in a subset of cases involving chronic pain management. RESULTS: During the study period, 58 cases were eligible for final analysis. There were 27 cases related to complex regional pain syndrome (CRPS), many of them involving problems with financial compensation (24/27, 88.9%). The CRPS cases showed male dominance (22 males, 5 females). In a disproportionately large number of these cases, the causative injury occurred during military training (n = 5). Two cases were associated with noninvasive pain managements, and 29 cases with invasive procedures. Of the latter group, procedures involving the spine (both neuraxial and non-neuraxial procedures) resulted in more severe complications than other procedures (P = 0.007). Seven of the patients who underwent invasive procedures died. The most common type of invasive procedures were lumbosacral procedures (16/29, 55.2%). More specifically, the most common damaging events were inadvertent intravascular or intrathecal injection of local anesthetics (n = 6). CONCLUSIONS: Several characteristics of medical disputes related to chronic pain management were identified: the prevalence of injury benefit claims in CRPS patients, higher severity of complications in procedures performed at the spine or cervical region, and the preventability of inadvertent intravascular or intrathecal injection of local anesthetics.
Anesthetics, Local ; Chronic Pain* ; Compensation and Redress ; Dissent and Disputes* ; Humans ; Injections, Spinal ; Legislation, Medical ; Male ; Malpractice ; Military Personnel ; Pain Management ; Prevalence ; Spine

This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit.
Humans ; *Liability, Legal ; Malpractice/*legislation & jurisprudence ; Reconstructive Surgical Procedures/adverse effects/legislation & jurisprudence ; Republic of Korea ; Surgery, Plastic/*adverse effects/*legislation & jurisprudence

OBJECTIVE: To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. METHODS: One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. RESULTS: The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). CONCLUSION Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.
Cause of Death ; China ; Diagnostic Errors/statistics & numerical data* ; Expert Testimony/legislation & jurisprudence* ; Female ; Forensic Medicine ; Humans ; Informed Consent ; Intraoperative Complications/mortality* ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Surgical Procedures, Operative

Aged ; Carcinoma, Squamous Cell ; surgery ; Dentists ; legislation & jurisprudence ; Female ; Humans ; Liability, Legal ; Malpractice ; legislation & jurisprudence ; Surgical Flaps ; Tongue Neoplasms ; surgery ; Treatment Failure

OBJECTIVE: To explore procedures and methods of forensic investigation for the death cases of aortic dissection with disputes. METHODS: Twenty-one death cases of aortic dissection with disputes from 2006 to 2011 were collected. All the data were analyzed to investigate the reasons and features of the disputes. RESULTS: The main causes of the disputes were clinical misdiagnosis or slight force. The pathologic type of De Bakey (I and II) or Stanford A were common in each case. For the cases dying of aortic dissection, it was significantly important to detect the rupture of entry and exit and observe the dissection of arterial wall. CONCLUSION The main causes of clinical misdiagnosis are insufficient experiences, careless observation and curtness in medical treatment. The difficult points in these cases are confirmation of the relationships between injury and disease, the primary affection and complication.
Adult ; Aged ; Aged, 80 and over ; Aortic Dissection/pathology* ; Aorta/pathology* ; Aortic Aneurysm/pathology* ; Autopsy ; Cause of Death ; Diagnostic Errors ; Female ; Forensic Pathology/methods* ; Humans ; Male ; Malpractice/legislation & jurisprudence* ; Middle Aged ; Violence ; Young Adult

Dentists ; legislation & jurisprudence ; Discriminant Analysis ; Dissent and Disputes ; legislation & jurisprudence ; Expert Testimony ; legislation & jurisprudence ; Humans ; Liability, Legal ; Malpractice ; legislation & jurisprudence ; Quality Control

Adult ; Delivery of Health Care ; legislation & jurisprudence ; Dental Implantation ; Dentists ; legislation & jurisprudence ; Dissent and Disputes ; Female ; Humans ; Liability, Legal ; Male ; Malocclusion ; therapy ; Malpractice ; legislation & jurisprudence ; Maxilla ; abnormalities ; Middle Aged ; Orthodontics, Corrective ; legislation & jurisprudence ; Tooth Loss ; surgery ; Treatment Failure

Adolescent ; Child ; Dentists ; legislation & jurisprudence ; Dissent and Disputes ; legislation & jurisprudence ; Female ; Hepatitis B Surface Antigens ; analysis ; Humans ; Liability, Legal ; Male ; Malocclusion ; therapy ; virology ; Malpractice ; legislation & jurisprudence ; Orthodontics, Corrective ; Refusal to Treat ; Tooth Extraction

Adolescent ; Dental Amalgam ; adverse effects ; therapeutic use ; Dental Caries ; therapy ; Dentists ; legislation & jurisprudence ; Dissent and Disputes ; legislation & jurisprudence ; Female ; Humans ; Impetigo ; chemically induced ; Liability, Legal ; economics ; Licensure ; Malpractice ; legislation & jurisprudence ; Metacarpus ; Toes

BACKGROUND: Since 2009, database construction of anesthesia-related adverse events has been initiated through the legislation committee of the Korean Society of Anesthesiologists (KSA), based on expert consultation referrals provided by police departments, civil courts, and criminal courts. METHODS: This study was a retrospective descriptive analysis of expert consultation referrals on surgical anesthesia-related cases between December 2008 and July 2010. RESULTS: During the given period, 46 surgical anesthesia-related cases were referred to the KSA legislation committee for expert consultation. Because six cases were excluded due to insufficient data, 40 cases were included in the final analysis. Of 40 cases, 29 (72.5%) resulted in death. Respiratory events were most common in both surviving/disabled and dead patients (36.4 vs. 51.7%, respectively; P > 0.05). Overall, respiratory depression due to the drugs used for monitored anesthesia care (MAC) was the most common specific mechanism (25%), in which all but one case (profound brain damage) resulted in death. In all of these cases, surgeons or physicians provided MAC without the help of anesthesiologists. CONCLUSIONS: Overall, the most common damaging mechanism was related to respiratory depression due to sedatives or anesthetics used for MAC. Almost all MAC injury cases are believed to be preventable with the use of additional or better monitoring and an effective response to initial physiological derangement. Thus, it is essential to establish practical MAC guidelines and adhere to these guidelines strictly to reduce the occurrence of severe anesthesia-related adverse outcomes.
Anesthesia ; Anesthetics ; Brain ; Criminals ; Humans ; Hypnotics and Sedatives ; Legislation, Medical ; Malpractice ; Police ; Referral and Consultation ; Respiratory Insufficiency ; Retrospective Studies