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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 王炯珵 | 泌尿科醫師的誤診導致賠償 | 2007/12/8 下午 04:38:35 | 0 |
| 原 文 | 題 目 | Missed diagnoses by urologists resulting in malpractice payment. |
| 作 者 | Badger WJ, Moran ME, Abraham C, Yarlagadda B, Perrotti M | |
| 出 處 | Journal of Urology | |
| 出版日期 | 2007 Dec;178(6):2537-9. | |
| 評 論 |
大家可能都根深蒂固地認為, Journal of Urology只會刊登相關泌尿科偉大的科學發現,從住院醫師開始的期刊讀書會,師長也總是告訴我們這些臨床和基礎的研究成果可以带給我們病患健康如何的提升和維護,可是隨著醫病關係的改變,行醫時應該注意的事項似乎也有所改變｡ 本研究是收集1995至2004年這二十年之間在紐約州的醫療責任共同保險公司發生病患申訴案件,總共有469件申訴,其中75件是屬於誤診申訴,共賠了約3千2百萬美金｡平均一件賠43萬美金,其中34件没診斷病患有癌症,平均賠52萬美金｡這算是單價最高的! 這75件未包括上法院或仲裁後對醫師勝訴的判決,而這些費用包括了律師費､出庭費､專家作證費,這些加起來可不是小數目,雖然醫師勝訴了但這些費用還是要支付的! 醫療過失的天價賠償價在台灣已非新聞,如何因應之道可能大家要集思廣益想一想才行,本人強烈推薦這篇作為各大醫學中心期刊讀書會的必讀文章｡ |
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| abstract |
PURPOSE: Missed diagnoses are a patient safety concern and they can result in malpractice allegation. The specialist physician may be liable for missed or delayed diagnoses even if an abnormality in the physician area of expertise is ruled out. We approached this largely unstudied area of medical malpractice in an effort to increase physician awareness and identify opportunities for prevention. MATERIALS AND METHODS: Working with the Medical Liability Mutual Insurance Company of New York State, we evaluated malpractice claims in urology that were closed with indemnity payment between 1985 and 2004. We identified all such claims resulting from alleged missed or delayed diagnoses by urologists. Claims were divided into 2 main categories based on whether the missed diagnosis was primarily urological, ie testis torsion, or not urological, ie appendicitis. RESULTS: A total of 75 missed diagnosis claims were identified, representing 15% of claims overall. The total indemnity payment for missed diagnosis claims was $32,591,013, which represented 27% of all indemnity payments for the study period. They were divided into 58 missed urological diagnoses and 17 missed nonurological diagnoses. Cancer represented 71% of missed urological diagnoses and 41% of missed nonurological diagnoses. Urological cancer missed diagnosis claims were associated with the highest average indemnity payment of $526,460. The average indemnity payment for missed diagnosis claims was 92% greater than the average indemnity payment for all other claims ($434,546 vs $226,133). An increase in the frequency of missed diagnosis claims closed with indemnity payment and in the amount of payment for missed diagnosis claims were observed during the 20-year study period. CONCLUSIONS: Indemnity payments resulting from missed diagnosis claims represent a disproportionately high percent of total indemnity payments (27%) due to a high average payment for such claims. Liability for the urologist resulted from missed diagnoses not only of urological conditions, but also of nonurological conditions. |
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