Editorial – Medical litigation in the 21st century

The possibility of a medical negligence claim lies at the back of many doctors’ minds. But which specialties see the greatest and fewest claims, and what are the potential costs to the NHS of a successful claim? In their article, Dr Lane et al. analyse 10 years’ NHS litigation data, broken down by specialty, number of claims, and the attendant cost of those claims which were successful. Litigation in the ‘post Montgomery’ era is considered along with some of the common factors which may lead to a patient or their family taking legal action.

Dissecting Medical Litigation: An Analysis of Canadian Legal Cases in Plastic Surgery

Introduction: Plastic surgeons are more likely to face medical litigation, compared to other specialists. Although this has been previously studied in other countries, there is a paucity of data regarding legal medical cases within Canada. The goal of this study was to compile and analyze all medical litigations in plastic surgery in Canada and identify themes associated them. Methods: A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada and WestLawNext Canada, was conducted to retrieve all legal medical cases against plastic surgeons in Canadian courts. Quantitative and qualitative analyses were performed to dissect the characteristics of plastic surgery litigation in Canada. Results: A total of 105 legal cases were included in this analysis, including 81 lawsuits and 24 appeals. The preponderance of cases was related to breast surgeries (47.0%), followed by head and neck surgeries (18.1%), with 76.5% being related to cosmetic surgery; 64.2% were ruled in favour of the surgeon. The lack of preoperative informed consent was highly associated with a final ruling in favour of the patient ( P < .0001). The average monetary value of damages awarded was $61 076. There was no significant difference in monetary value between cosmetic and reconstructive cases. Conclusion: The majority of medical litigation in plastic surgery in Canada is associated with cosmetic surgeries, most commonly of the breast. Lack of informed consent is associated with judicial rulings in favour of patients. By understanding the themes underlying these legal cases, we hope to highlight the main issues that lead to litigation in plastic surgery.

Disciplinary law and neurosurgery: a 10-year analysis of cases in the Netherlands

OBJECTIVENeurosurgery is historically seen as a high-risk medical specialty, with a large percentage of neurosurgeons facing complaints during their careers. The Dutch medicolegal system is characterized by a strong emphasis on informal mediation, which can be accompanied or followed by disciplinary actions. To determine if this system is associated with a low overall risk for medical litigation through disciplinary law, the authors conducted a review of disciplinary cases involving neurosurgeons in the Netherlands.METHODSThe authors reviewed legal cases that had been filed against consultant neurosurgeons and neurosurgical residents under the Dutch disciplinary law for medical professions between 2009 and 2019.RESULTSA total of 1322 neurosurgical care–related cases from 2009 to 2019 were reviewed. Fifty-seven (4.3%) cases were filed against neurosurgeons (40 first-instance cases, 17 appeal cases). In total, 123 complaints were filed in the 40 first-instance cases. Most of these cases were related to spine surgery (62.5%), followed by cranial surgery (27.5%), peripheral nerve surgery (7.5%), and pediatric neurosurgery (2.5%). Complaints were filed in all stages of care but were mostly related to preoperative and intraoperative care.CONCLUSIONSThe risk for medically related litigation in neurosurgery in the Netherlands through disciplinary law is low but not negligible. Although the absolute number of cases is low, spinal neurosurgery was found to be a risk factor for complaints. The relatively high number of cases that involved the sharing of information suggests that specific improvements—focusing on communication—can be made in order to lower the risk for future litigation.

Study on the Causes and Countermeasures of Medical Complaints during the Outbreak of Novel Coronavirus Disease

To investigate the medical complaints status and coping styles during the outbreak of the novel coronavirus diseases. Methods: 86 cases medical complaints of uninfected novel coronavirus disease, which collected from one hospital at Beijing city during the January-March 2020, have been retrospectively analyzed. The number, types and causes, department distribution have been evaluated at different stages. Results: During the epidemic, medical complaints are still one of the severe problems faced by hospitals, the number of medical complaints, was significantly higher than those during the non-epidemic, Emergency, Neurology and Neurosurgery were as the top three departments. Failure to admission to hospital as scheduled or as expected was an important and special reason in the medical complaints. Most of medical complaints were gain understanding and cooperation by effective communication, only 4 cases of complaints were application for Legal mediation procedure legal. Conclusion: Medical complaints during the outbreak is a serious problem facing by hospitals, which should be given the necessary attention and positive response to reduce the risk of related medical litigation cases at post-epidemic stage.

How Mr Slop identifies a difficult patient

Our scribe reflects on medical litigation cases... can they be predicted?

Miscellaneous

This chapter describes covers the legal and professional standards of care required in palliative medicine, including the Mental Capacity Act, lasting power of attorney, and restraint or deprivation of liberty. Medicine frequently poses complex situations that as clinicians can challenge our understanding of the legal and ethical framework we work within. The legal framework is structured to protect patients and doctors, and provide guidance in dealing with what can sometimes be unclear and difficult situations. In addition, doctors, like all other healthcare professionals, work in an increasingly litigious and legally regulated environment. Sadly, for both patients and doctors, at times a simple failure by doctors to appreciate the nature and extent of their legal and professional responsibilities can lead to significant medico-legal problems. Furthermore, clinical negligence is covered, including landmark cases in medical litigation. The process for death certification and referral to the coroner is covered, and fitness to drive DVLA requirements are explained. Plans for travelling abroad during the end of life, donor requirements, and a selection of useful resources for patients and laboratory reference values are included.