scholarly journals Gross negligence ‘medical’ manslaughter in Ireland: Legal context and clinician concerns

2021 ◽  
pp. 096853322110570
Author(s):  
Mary-Elizabeth Tumelty ◽  
Eimear Spain
Keyword(s):  
Patient Safety ◽  
Medical Practice ◽  
Defensive Medicine ◽  
Criminal Prosecution ◽  
Medical Practitioners ◽  
Legal Context ◽  
Public Consciousness ◽  
The Republic ◽  
The Impact ◽  
Patient Safety Incidents

In recent years, the prospect of the criminal prosecution of medical practitioners for patient safety incidents resulting in fatality which occur in the course of clinical practice has caused heightened anxiety among medical practitioners, particularly in England and Wales, where a number of high-profile cases have raised public consciousness of this issue. The full impact of this landscape on individual practitioners and the delivery of healthcare has yet to be ascertained, although research suggests that medical practice has been impacted. Of particular interest is the phenomenon of defensive medicine which occurs where physicians adopt assurance and/or avoidance behaviours in an attempt to minimise the risk of medical negligence litigation and/or to avoid complaints to regulatory bodies. While defensive medicine is traditionally conceived of in a civil context, the possibility of criminal prosecution for patient safety incidents resulting in fatality may also result in alterations to medical practice. Drawing on the findings of an empirical study (a survey), this research sought to explore the impact, if any, of the threat of criminal prosecution on surgical practice in the Republic of Ireland, including a potential rise in defensive practice.

scholarly journals Prolonged mental health sequelae among doctors and nurses involved in patient safety incidents with formal complaints and lawsuits

2019 ◽  
Vol 30 (4) ◽  
pp. 777-779
Author(s):  
Gerda Zeeman ◽  
Loes Schouten ◽  
Deborah Seys ◽  
Ellen Coeckelberghs ◽  
Philomeen Weijenborg ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Safety ◽  
Related Disorder ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
Formal Complaint ◽  
The Impact ◽  
Patient Safety Incidents ◽  
Doctors And Nurses

Abstract We evaluated the presence of prolonged mental health sequelae in the aftermath of a patient safety incident and the impact of a formal complaint or lawsuit on these mental health sequelae in 19 hospitals and 2635 nurses and doctors. Of 2635 respondents, 983 (37.3%) reported a complaint and 190 (7.2%) reported a lawsuit. In both doctors and nurses prolonged mental health sequelae reflecting a stressor-related disorder were highly prevalent, each well over 20% overall. They were consistently more prevalent in case of a formal complaint or lawsuit. Lawsuits showed 2-, 3- and 4-fold increases in prevalence of mental health sequelae.

The Impact of Controlled Substance Federal Regulation on the Practice of Pharmacy

1995 ◽  
Vol 8 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Frederick H. Branding
Keyword(s):  
Medical Practice ◽  
Criminal Prosecution ◽  
Federal Regulation ◽  
Drug Enforcement ◽  
Controlled Substances ◽  
Drug Enforcement Administration ◽  
Controlled Substance ◽  
The Impact

The federal Controlled Substances Act requires all registrants, including pharmacists, to keep complete, accurate, and detailed records of the acquisition and disposition of all controlled substances. These records are to be maintained in a readily retrievable manner in order that they may be inspected, verified, and copied by inspectors of the Drug Enforcement Administration. When dispensing controlled substances, pharmacists have a statutorily imposed corresponding responsibility to verify that all prescriptions for controlled substances have been issued by a prescriber in the usual course of that prescriber's legitimate medical practice. Violations of the Controlled Substances Act and regulations can subject pharmacists to a variety of sanctions, ranging from an administrative letter of admoni tion to a civil fine, forfeiture, or criminal prosecution. Copyright © 1991 by W.B. Saunders Company

The Impact of Controlled Substance Federal Regulation on the Practice of Pharmacy

1991 ◽  
Vol 4 (6) ◽  
pp. 372-379
Author(s):  
Frederick H. Branding
Keyword(s):  
Medical Practice ◽  
Criminal Prosecution ◽  
Federal Regulation ◽  
Drug Enforcement ◽  
Controlled Substances ◽  
Drug Enforcement Administration ◽  
Controlled Substance ◽  
The Impact

The federal Controlled Substances Act requires all registrants, including pharmacists, to keep complete, accurate, and detailed records of the acquisition and disposition of all controlled substances. These records are to be maintained in a readily retrievable manner in order that they may be inspected, verified, and copied by inspectors of the Drug Enforcement Administration. When dispensing controlled substances, pharmacists have a statutorily imposed corresponding responsibility to verify that all prescriptions for controlled substances have been issued by a prescriber in the usual course of that prescriber's legitimate medical practice. Violations of the Controlled Substances Act and regulations can subject pharmacists to a variety of sanctions, ranging from an administrative letter of admonition to a civil fine, forfeiture, or criminal prosecution.

scholarly journals 1070. Handshake Antimicrobial Stewardship as a Model to Prevent Patient Safety Incidents and Recognize Diagnostic Errors

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S379-S379
Author(s):  
Justin B Searns ◽  
Manon Williams ◽  
Christine MacBrayne ◽  
Ann Wirtz ◽  
Sarah Parker ◽  
...  
Keyword(s):  
Patient Safety ◽  
Antimicrobial Stewardship ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Care Patient ◽  
Patient Harm ◽  
Administration Error ◽  
Category Labels ◽  
The Impact ◽  
Patient Safety Incidents

Abstract Background Patient safety incidents (PSIs), such as diagnostic errors, are common events that may lead to significant patient harm. Few studies describe the impact that antimicrobial stewardship programs (ASPs) have preventing PSIs and recognizing diagnostic errors. Handshake Stewardship has emerged as a specific ASP model that involves prospective review of hospital-wide antimicrobial ordering with a compressed “second look” of relevant clinical and historical patient data. In person recommendations are then provided directly to the medical team. The objective of this project was to evaluate the potential impact that Handshake Stewardship has on preventing PSIs and recognizing diagnostic errors. Methods Following Children’s Hospital Colorado (CHCO) ASP’s implementation of the Handshake Stewardship model in October 2013, the CHCO ASP team began prospectively self-labeling interventions as “Great Catches” (GCs). These GCs were defined as any ASP intervention that “notably changed the trajectory of patient care.” Patient charts for all GCs from October 2014 through May 2018 were retrospectively reviewed and each intervention was assigned one or more descriptive category labels including: administration error, de-escalation/escalation of therapy, bug-drug mismatch, inappropriate dose/duration, potential adverse effect, alternative diagnosis, additional testing, prevent hospital admission, and epidemiology alerts. In addition, each intervention was scored using the previously validated “Safer Dx Instrument” to determine which GCs intervened on a potential diagnostic error. Results From October 2014 through May 2018 there were 87,322 admissions to CHCO. Our ASP team intervened on 6,735/87,322 (7.7%) of these admissions. Of these, 174/6,735 (2.6%) were prospectively labeled by ASP providers as GCs, of which 44/174 (25%) resulted in new infectious disease consultations. Conclusion Given the frequency and significance of PSIs including diagnostic error, systems are needed to help recognize and prevent patient harm. The Handshake Stewardship model may help prevent PSIs and recognize diagnostic errors among hospitalized children. Disclosures All authors: No reported disclosures.

An analysis of general practitioners’ perspectives on patient safety incidents using critical incident technique interviews

2019 ◽  
Vol 36 (6) ◽  
pp. 736-742 ◽  
Author(s):  
Ciara Curran ◽  
Sinéad Lydon ◽  
Maureen E Kelly ◽  
Andrew W Murphy ◽  
Paul O’Connor
Keyword(s):  
Patient Safety ◽  
General Practitioners ◽  
Critical Incident ◽  
Improve Patient Safety ◽  
Critical Incident Technique ◽  
Contributory Factor ◽  
Contributory Factors ◽  
Safety Incident ◽  
The Impact ◽  
Patient Safety Incidents

Abstract Background General practitioners report difficulty in knowing how to improve patient safety. Objectives To analyse general practitioners’ perspectives of contributing factors to patient safety incidents by collecting accounts of incidents, identifying the contributory factors to these incidents, assessing the impact and likelihood of occurrence of these incidents and examining whether certain categories of contributory factors were associated with the occurrence of high-risk incidents. Methods Critical incident technique interviews were carried out with 30 general practitioners in Ireland about a patient safety incident they had experienced. The Yorkshire Contributory Factors Framework was used to classify the contributory factors to incidents. Seven subject matter experts rated the impact and likelihood of occurrence of each incident. Results A total of 26 interviews were analysed. Almost two-thirds of the patient safety incidents were rated as having a major-to-extreme impact on the patient, and over a third were judged as having at least a bimonthly likelihood of occurrence. The most commonly described active failures were ‘Medication Error’ (34.6%) and ‘Diagnostic Error’ (30.8%). ‘Situational Domain’ was identified as a contributory domain in all patient safety incidents. ‘Communication’ breakdown at both practice and other healthcare-provider interfaces (69.2%) was also a commonly cited contributory factor. There were no significant differences in the levels of risk associated with the contributory factors. Conclusions Critical incident technique interviews support the identification of contributory factors to patient safety incidents. There is a need to explore the use of the resulting data for quality and safety improvement in general practice.

Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study

2016 ◽  
Vol 31 ◽  
pp. 34-46 ◽  
Author(s):  
E. Van Gerven ◽  
D. Deweer ◽  
S.D. Scott ◽  
M. Panella ◽  
M. Euwema ◽  
...  
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
The Impact ◽  
Patient Safety Incidents

scholarly journals Criminal Prosecution of Doctors in Indonesia: Issues and Problems

2015 ◽  
Vol 23 ◽  
Author(s):  
Muh Endriyo Susila
Keyword(s):  
Law Enforcement ◽  
Field Study ◽  
Medical Malpractice ◽  
Law Enforcement Officers ◽  
Defensive Medicine ◽  
Criminal Prosecution ◽  
Negative Consequences ◽  
The Law ◽  
The Impact

Criminal prosecution of doctors due to medical malpractice has created controversy in Indonesia. The purpose of the research is to find out the impact of criminal prosecution of doctors in Indonesia, particularly those due to medical malpractice cases. The data were collected through both library-based study and field study in the form of interviews. It is found that criminal prosecution of doctors in the context of medical malpractice has brought about negative consequences such as the exploitation of doctors by law enforcement officers and the practice of defensive medicine. It is found that criminal prosecution of doctors due to medical malpractice should be limited in order to promote justice in the medical malpractice issue. The article concludes with some elaboration on the necessary reforms required in regard to the law relating to medical malpractice in Indonesia.

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