No fault compensation in perinatal medicine in Japan-from results for 8 years

No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient's family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.

A Study on the Current Status of Medical Lawsuits in Orthopedics in Korea / 대한정형외과학회잡지

PURPOSE: Through the analysis of orthopedics lawsuit rulings, the purpose of this study is to understand the current trends of medical lawsuits in orthopedics in Korea. MATERIALS AND METHODS: An analysis of medical lawsuits in orthopedics was conducted. As the study method, a quantitative analysis was performed on 341 cases. RESULTS: The average period of lawsuits, from the occurrence of the medical accident to end of the ruling, took an average of 4.22 years. The most frequent procedure that was the main cause of the medical accidents was surgery, at 46.3%. When surgery is the main procedure that caused the medical accidents, the result of examining the types of surgeries showed that spine surgery had the highest percentage. For the outcome of the accident, the highest number of cases resulted in disability and for the final court outcome, 40.5% ruled partially in favor of the plaintiff (the patient) with acknowledgement of only the damage incurred due to medical error of the total sum claimed, and dismissal of the claim made by the plaintiff (patient) accounted for 34.3%; 26.1% of cases develop infection. For the amount of claim for damage, the average amount of claim was 181,998,036 won; in the judgement amount, the average amount of judgement was 58,897,161 won. CONCLUSION: The most frequent procedure in orthopedics was surgery and spine surgery comprised a large proportion of these surgeries. Future studies to determine root causes of medical accidents should be conducted to reduce medical lawsuits and to plan against the repeating of medical accidents.

Issues hospitals need to pay attention to in medical lawsuits / 中华医院管理杂志

Hospitals frequently end up losing medical lawsuits due to the following factors: inappropriate appointment of legal representatives, misconception and wrong application of the standard of proof required for lawsuits, ignorance of the time limit for submitting lawsuit documents, and lack of communication with the judges on the proof value of medical literature. In order to guarantee their legitimate rights and interests, hospitals ought to appoint health lawyers and medical experts as their legal representatives, have a good grasp of the standard of proof of reasonable probability, adhere to the time regulations in lawsuits, strengthen communication with the judges with regard to medicine, and understand the legal rules of arbitration. Only by doing so can their legal rights and interests avoid being encroached upon.

The trend of strict liability: reflection on current trials for medical dispute lawsuits / 中华医院管理杂志

Existing laws in China indicate that the fault liability doctrine should be applied in tort lawsuits. However, there is currently the trend in the judicial field of applying strict liability with regard to medical institutions. Strict liability, realized chiefly through the reversal of the burden of relief, stresses the protection of the victims. By citing typical cases, the authors analyze the application of strict liability in medical malpractice disputes: ①Patients have no burden of relief on whether hospitals made errors in the harms brought about. ②There are limitations to reasons for hospitals to get exempted from liabilities; they cannot use reasonable care as pleas. ③The relationship between medical actions and patients' damages is presumed. The authors hold that although the use of strict liability may improve reasonable care by medical workers, yet when mature medical liability insurances are not in place, the application of strict liability in trials adds to the liability of medical institutions and their staff and cannot lead to genuine settlement of patient-doctor disputes. judicial institutions ought to apply strict liability in strict accordance with the law and avoid making compensations for patients at the compromise of judicial justice.