Dental mapractice litigance in the city of São Paulo (SP), Brazil

The relationship between patients and dentists today is more worn and less based on trust, which can lead to high rates of lawsuits related to civil liability and dental malpractice. Aim: verify if there has been an increase in the number of lawsuits related to questioned dental treatments, and against dentists registered in the city of São Paulo (SP), Brazil, from 2012 to 2017. Methods: We outlined an overview based on the list from the São Paulo Council of Dentistry containing 30,238 registered dentists in the city of São Paulo, and searched for lawsuits on the public base of the São Paulo State Court's. Results: The search, after the inclusion and exclusion criteria, found 247 lawsuits, with dental implants as the most involved specialty. The total indemnities requested ranged from R$ 227.42 to R$ 937,000.00, but no indemnity granted exceeded the amount of R$ 100,000.00. Conclusion: According to the analysis of cases, there is a progressive increase in the number of civil liability lawsuits against dentists involving dental malpractice litigance

Responsabilidad civil médica y contrato de seguro: sobre las cláusulas de delimitación temporal / Medical liability and insurance contract: about claims made clause

Resumen: El presente artículo tiene por objeto dar a conocer un particular tipo de cláusula que puede encontrarse en las pólizas de seguro por actividades profesionales: la cláusula de delimitación temporal llamada claims made. Ésta presenta múltiples problemáticas desde el punto de vista jurídico, que tienen directa incidencia en el ámbito práctico de la responsabilidad médica. Una de ellas, se produce en aquellos casos en que los siniestros no reciben cobertura de la compañía, aun estando vigente y debidamente pagada la póliza por el asegurado, debiendo asumirse el pago de la indemnización por el propio médico frente a la víctima.

Abstract: The purpose of this paper is to present a particular type of clause that can be found in an insurance contract related to professional activities: the claims made clause. This clause presents multiple legal problems which have a direct impact on the practical application in the medical liability. One of these occurs in cases where the damage is not covered by the insurance company even if the policy has been properly paid by the insured, and the compensation must be paid by the doctor to the victim.

Current situation and countermeasures of medical damage risk sharing system in China / 中南大学学报(医学版)

Although medical damage risks really exist, an effective medical risk sharing system is still not available in China right now. By analyzing the status quo of Chinese medical damage risks sharing system, the authors put forward the following suggestions to improve the current system: Upgrading the preventive strategy for medical disputes, establishing multi-level and multi-channel comprehensive medical damage risks sharing system, promoting the effective cooperation between insurance relief systems and mediation system for medical disputes, and constructing highly effective pathways to resolve the medical disputes.

Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

BACKGROUND: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. METHODS: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. RESULTS: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. CONCLUSIONS: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

Changes in the Cesarean Section Rate in Korea (1982-2012) and a Review of the Associated Factors

Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country. The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective. To optimize the CSR in Korea, efforts on lowering the maternal childbearing age or reducing maternal obesity are needed at individual level. And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.

La Responsabilidad Civil Médica / Medical Liability

A la hora de gerenciar y administrar determinado establecimiento sanitario o servicio de salud, existen una multiplicidad de variables, entre ellas la jurídica, que deben mantenerse balanceadas y controlas para mantener un equilibrio financiero, contable y económico sustentable y sostenido que permita el mantenimiento del uncionamiento y el crecimiento de la empresa. Sin embargo, la realidad demuestra que muchas empresas han sido víctimas de contingencias legales que han acabado con su ruina. Es por ello que en este trabajo de tesis se buscó identificar y analizar los distintos supuestos de la“Responsabilidad Civil Médica” que pueden surgir y afectar a los profesionales de la salud, entidades sanatoriales, obras sociales, empresas de medicina prepaga y al estado mismo en sus distintos ordenes, nacional, provincial o municipal .En especial se abarcó el estudio de la “Responsabilidad Civil Médica Individual”, la“Responsabilidad Civil Médica Colectiva”, sus diversas especies, la “Responsabilidad Civil del Grupo Médico”, la “Responsabilidad Civil de Equipo Médico” y la “Perdida deChance”. El resultado de dicho trabajo fue el siguiente, se encontraron diversos tipos de responsabilidad con alcances diferentes respecto al profesional involucrado, al resto de los profesionales y demás instituciones y entidades involucradas. En todas ellas los efectos conómicos pueden ser sumamente perjudiciales o hasta devastadores para los agentes involucrados, pero dichas consecuencias pueden prevenirse, evitarse y/o minimizarse con una buena praxis médica y sanatorial.

SUMMARY: When it comes to managing a certain sanitary institution or health service provider, there are multiple variables: among them legal, that need to be balanced to keep a financial equilibrium and economic sustainability allowing proper performance and growth. However, past experience has and continues demonstrating that many companies have been victims of legal contingencies that resulted in bankruptcy. This thesis attempts to identify and analyze different suppositions of “Civil Medical Responsibility” that may surface and affect health professionals; Health Maintenance Organization; prepaid medicine and government. Special attention has been given to “Indivdual Civil Medical Responsibility”, “Collective Civil Medical Responsibility”, “Civil Medical Group responsibility”, “Civil Medical Staff Responsibility” and “Lost chance” . The result of said paper was the following: diverse types of responsibilities with different degrees of involvement were reported. Parties include: health professionals and institutions. In all cases the economic impact can beoverwhelming and devastating for the parties involved, but such damages can be prevented or minimized with good medical praxis.

Perception of dental surgeons on the ethical and legal aspects of exercising their profession as personal and corporate entities

Aim: To evaluate the level of knowledge of dentists of the ethical and legal aspects of exercisingtheir profession as individual and corporate entities; to observe the level of knowledge ofprofessionals on the main taxes inherent to their existence as individual and corporate entities;and to highlight the positive and negative aspects of each entity. Methods: A questionnaire wasprepared containing structured and open questions, which was sent to dentists working in thecities of Betim and Contagem (Belo Horizonte metropolitan area) in letters containing self-addressedstamped envelopes for return to the research team. The data were analyzed using descriptivestatistics. Results: 77.9% of professionals work as individual entities, 19.7% as individual andcorporate entities, and only 2.5% act solely as corporate entities. Of the professionals who workas corporate entities, 88.8% reported that the reason that led them to act as individual and/orcorporate entities was a requirement by health plans. With regard to taxes imposed on each typeof entity, 67.4% of individual entity professionals declared not knowing the main taxes related totheir profession. Conclusions: The level of knowledge of dentists regarding the ethical and legalimplications of performing their profession as individual and corporate entities is insufficient; theinterviewed professionals are not properly trained on the pertinent ethical and legal aspects oftheir profession, thus becoming vulnerable to litigation; and these professionals do not haveknowledge on the main taxes related to each type of legal entity.

Responsabilidad profesional médica: Diagnóstico y perspectivas / Perspectives in medical liability

The progressive increase of medical negligence law suits requires an updated analysis of the current situation of medical liability in Chile. The application of a new criminal procedure will avoid criminal prosecution of doctors, transfering to the civil courts the pecuniary sanctions for malpractice. Medical negligence and damage inflicted by doctors that require compensation are explained. The most likely evolution of medical liability is proposed, through an increase in civil liability insurances and the necessary standardization of rules applicable to profesional liability.

Medical liability. the dilemma of litigations

all of the physicians are ill prepared when it comes to facing a medical litigation. Having witnessed that first hand on numerous occasions made me decide to write on this issue to offer some insight and advice on the matter as it is obvious no one is immune in the medical profession. In addition, the number of medical litigation cases is on the rise. There is no doubt that the matter is of great importance not only to doctors, medical and dental students but also to other health care workers. The data of the cases submitted to the Medico-legal committee of the Ministry of Health, Riyadh, Kingdom of Saudi Arabia from various parts of the country for the period 1420 through to 1423 H [1999-2003] were examined and analyzed. A total of 2223 cases were referred to the various committees over the past 4-years for considerations. Obstetrics lead the way in being the most litigation prone medical specialty. Surgery takes the second place followed by internal medicine pediatrics being the fourth in order of frequency. The other specialties are some where in between. Least number of malpractice lawsuits were filed against the dental profession. Litigations can not be totally prevented but it could be limited to only the legitimate ones

Demandas por responsabilidad profesional: respuestas del Distrito VIII del colegio médico de la provincia de Buenos Aires / Professional responsability demands: distrito VIII Medical Colege of Buenos Aires State acts

Antecedentes: Las demandas por Responsabilidad Profesional constituyen uno de los principales problemas de los médicos. El Distrito VIII del Colegio Médico de la Provincia de Buenos Aires creó el Fondo de Ayuda Profesional (FAP) como herramienta para enfrentar los conflictos médicos-legales. Objetivo: Dar a conocer el FAP, cómo está formado, los instrumentos que posee para hacer frente a estos problemas y en especial explicar cuál es el sentido del mismo. Marco de Referencia: Colegio Médico Distrito VIII: Provincia de Buenos Aires. Diseño: Estudio retrospectivo y descriptivo. Población: Consultas y demandas desde enero de 1993 hasta mayo de 2002. Las consultas fueron 293 y sólo hubo 101 demandas que involucraron a 129 médicos. Las causas son 18, 14 en la justicia penal y 4 en la civil. Conclusiones: El FAP se creó porque la mayoría de los médicos no poseen cobertura en Compañías de Seguros, debido al alto costo de las pólizas. Además de la ayuda económica tiene un carácter preventivo. Es una estructura médica en defensa del médico

Cuidados ao contratar um seguro de responsabilidade civil / Take care of contracting a civil responsability insurance company

Nós, brasileiros, estamos copiando o modelo americano de processar todos o tempo todo. Hoje, estamos com mais de 9 milhöes de açöes indenizatórias, por ano. Nos Estados Unidos, todo médico e/ou cirurgiäo-dentista é processado três vezes durante a sua carreira. Isto é um dado estatístico e até explicável, pois, diferentemente do que ocorre no Brasil, a Constituiçäo americana näo garante saúde e o seguro e exerce o papel daquele mercado

Seguro de responsabilidade civil profissional / Professional liability insurance

Tendo em vista o aumento do número de açöes judiciais referentes à responsabilidade civil profissional e a utilizaçäo, também crescente, dos seguros privados como forma de prevençäo contra o ônus indenizatório, torna-se importante trazer à classe odontológica consideraçöes concernentes a esse tema. O objetivo deste trabalho é mostrar aos cirurgiöes-dentistas, ainda que de forma bastante breve, um panorama sobre os aspectos relevantes e cuidados necessários na contrataçäo desse incremento, colhida do jornal da Associaçäo Paulista de Cirurgiöes Dentistas, apresentamos a evoluçäo do número de açöes judiciais que estäo sendo interpostas em face dos cirurgiöes-dentistas segurados pela apólice coletiva experimental da APCD

La responsabilidad civil derivada de la investigación clínica en los servicios asistenciales de la Caja Costarricense de Seguro Social (CCSS) / The civil responsibility derived from the clinical investigation in the welfare services of the Caja Costarricense de Seguro Social

En Costa Rica se llevan a cabo investigaciones clínicas en los servicios asistenciales de la Caja Costarricense del Seguro Social, sin cumplirse con los requisitos establecidos en nuestro ordenamiento jurídico. Así, debe revisarse la regulación existente sobre el factor indemnizatorio que los participantes de la investigación clínica -patrocinador, investigador, institución pública o privada- deben cumplir y observar como elemento configurante del consentimiento informado, de forma tal que no se lleve a cabo la investigación si no se cuenta con una póliza obligatoria por parte de los promoventes, que cubra las diversas eventualidades de lesión y muerte del sujeto a experimentación. Palabras claves: Responsabilidad civil, investigación clínica, indenmización, consentimiento informado, patrocinador, investigador, tratamiento por lesiones, responsabilidad solidaria, obligaciones, derecho civil.