加拿大涉及颅外科的医学法律案件的趋势和影响因素。

IF 3.6 2区 医学 Q1 CLINICAL NEUROLOGY
Sean Barry, Katherine Tourigny, Tricia Barry, Patricia J Finestone, Richard Liu, Jacqueline H Fortier, Anna MacIntyre, Gary Garber
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引用次数: 0

摘要

目的:神经外科是一个低误差率的高风险专科,其医学法律风险高于其他许多专科。本研究的目的是提供当前加拿大颅外科的医学法律景观。方法:在这项回顾性描述性研究中,作者评估了10年(2012-2021)颅神经外科的数据,包括已提交给加拿大医疗保护协会(CMPA)的封闭法律诉讼、医疗监管机构(学院)案件和医院对神经外科医生的投诉。只有颅内病例,包括脑室-腹膜分流(VPS)放置或脑内导管或导线插入的病例,才有资格纳入研究。排除的病例包括儿童患者和血管造影、放射、超声或经皮手术。结果:76例颅脑病例纳入研究。神经外科医生的医学法律风险明显高于所有CMPA外科医生会员。民事诉讼案件占所有颅骨案件的一半以上。54%的病例有术后并发症,21%的病例有VPS安置。在所有数据中,沟通问题是导致医疗法律投诉的常见因素。结论:本文首次报道了加拿大法医学颅外科病例的经验。这些病例最常涉及肿瘤切除,VPS插入和减压颅骨切除术。VPS病例出乎意料地普遍,应进一步调查。通信中断是医学法律数据存储库的一个主要主题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends and contributing factors in medicolegal cases involving cranial surgery in Canada.

Objective: Neurosurgery is a high-risk specialty with a low margin of error, and neurosurgeons have a higher medicolegal risk than practitioners in many other specialties. The aim of this study was to provide a current medicolegal landscape of cranial surgery in Canada.

Methods: In this retrospective descriptive study, the authors evaluated 10 years (2012-2021) of cranial neurosurgical data on closed legal actions, medical regulatory authority (College) cases, and hospital complaints against neurosurgeons that had been submitted to the Canadian Medical Protective Association (CMPA). Only cranial cases, even those involving ventriculoperitoneal shunt (VPS) placement or catheter or wire insertion in the brain, were eligible for study inclusion. Excluded cases were those involving pediatric patients and angiography, radiation, ultrasound, or percutaneous procedures.

Results: Seventy-six cranial cases were included in the study. Neurosurgeons had a significantly higher medicolegal risk compared to that of the overall CMPA surgeon membership. Civil legal actions accounted for more than half of all the cranial cases. Fifty-four percent of cases involved postoperative complications, and 21% involved VPS placement. Communication issues were commonly named factors leading to a medicolegal complaint throughout the data.

Conclusions: This is the first report on the Canadian experience of medicolegal cranial surgery cases. These cases most commonly involved tumor excision, VPS insertion, and decompressive craniectomy. The VPS cases were unexpectedly common and should be further investigated. A breakdown in communication was a major theme in the medicolegal data repository.

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来源期刊
Journal of neurosurgery
Journal of neurosurgery 医学-临床神经学
CiteScore
7.20
自引率
7.30%
发文量
1003
审稿时长
1 months
期刊介绍: The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.
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