耳鼻喉科未获得知情同意的指控:对鼻窦外科医生的循证建议。

IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2023-05-01 DOI:10.1177/19458924221148566
Christian G Fritz, Dominic J Romeo, Anne S Lowery, Karthik Rajasekaran
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引用次数: 2

摘要

背景:知情同意要求术前讨论手术风险、并发症和替代治疗方案。不完全知情同意的指控在耳鼻喉科领域很常见。目的:分析耳鼻喉科医生涉嫌知情同意失败的病例的结果和病例变量。方法:一个包含美国各州和联邦案件记录的法律研究数据库对涉及知情同意和耳鼻喉科的医疗事故索赔进行回顾性审查。结果:在确定的128例知情同意病例中,72.6%的患者对耳鼻喉科医生做出了有利的判决。功能性内窥镜鼻窦手术(FESS)是耳鼻喉科领域最常见的知情同意诉讼来源,其发生率比次之的舌腭咽成形术高4倍(21.9%比5.4%)。fess相关病例中最常见的四个因素是脑脊液泄漏(10)、替代疗法讨论不足(4)、复视(3)和脑膜炎(3)。与永久性并发症(34.6%)的支付率相比,导致短暂性损伤的病例(9.1%)获得原告判决或和解的可能性显著降低(p = 0.005)。结论:未取得知情同意是医疗事故诉讼中的重要因素。本报告确定了具体的、可操作的建议,旨在保护鼻窦外科医生免受责任,并确保患者更好地了解情况。
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Allegations of Failure to Obtain Informed Consent in Otolaryngology: Evidenced-Based Recommendations for Sinus Surgeons.

Background: Informed consent requires preoperative discussion of surgical risks, complications, and alternative treatment options. Allegations of incomplete informed consent are common in the field of otolaryngology.

Objectives: Analyze outcomes and case variables in cases of alleged informed consent failure involving otolaryngologists.

Methods: A legal research database containing state and federal case records from across the United States was retrospectively reviewed for malpractice claims involving informed consent and otolaryngology.

Results: Among the 128 informed consent cases identified, 72.6% resulted in favorable verdicts for otolaryngologists. Functional endoscopic sinus surgery (FESS) was the most common source of informed consent litigation in the field of otolaryngology, with an incidence four-fold higher than the next most litigated procedure of uvulopalatopharyngoplasty (21.9% vs 5.4%). The top four factors cited in FESS-related cases were CSF leak (10), inadequate discussion of alternative therapies (4), diplopia (3), and meningitis (3). Cases resulting in a transient injury were significantly less likely to result in a payment from a plaintiff verdict or settlement (9.1%) as compared to payment-rates among cases involving permanent complications (34.6%) (p = 0.005).

Conclusions: Failure to obtain informed consent is an important factor in medical malpractice litigation. This report identifies specific, actionable recommendations aimed at protecting sinus surgeons from liability and ensuring that patients are better informed.

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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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