ABSTRACT
BACKGROUND: The number of treatment error procedures against physicians in Germany has been relatively constant at a high level for years, even though the allegation of a faulty medical procedure is confirmed statistically only in approximately one quarter of the cases. OBJECTIVE: Frequent and typical sources of error that can lead to the assertion of patient claims in the context of a medical treatment. MATERIAL AND METHODS: Evaluation of existing statistics of individual courts and arbitration boards. RESULTS: From a legal point of view the most common mistakes under the medical liability law can be divided into seven categories, which are the subject of dispute in almost all judicial or extrajudicial treatment error procedures. Due to the civil legal evidence situation thereby errors in disclosure of information take the top spot. CONCLUSION: Even by observing a few legal requirements, numerous liability traps can be avoided in the context of medical treatment.
Subject(s)
Liability, Legal , Malpractice , Germany , Humans , Lawyers , Medical Errors , NegotiatingABSTRACT
Through a more consistent diagnostics and treatment of osteoporosis, subsequent fractures and associated complications could be reduced in aged patients. Whereas anticoagulants are now standard in the treatment of fractures of the lower extremities to prevent thromboembolic complications in orthopedic surgery and an omission of anticoagulation can be regarded as medical malpractice, the management of osteoporosis following such fractures is very frequently disregarded. Although guidelines for osteoporosis, such as those from the governing body on osteology (Dachverband Osteologie, DVO) from 2014 are not legally binding as such, the breach of this standard of care can constitute a breach of medical obligation by the physician. The omission of osteoporosis diagnostics and initiation of treatment despite appropriate findings after fractures in aged patients, could represent a diagnostic assessment error and severe malpractice in the legal sense. In this case, evidence of a serious malpractice could be associated with civil, criminal and professional claims which could be linked with relevant legal consequences. Regardless of the legal consequences for omission of osteoporosis management following multiple fractures in aged patients, the management of osteoporosis should be an integral component in the treatment of these patients in the future.
Subject(s)
Medical Errors/legislation & jurisprudence , Medical Errors/prevention & control , Osteoporosis/diagnosis , Osteoporosis/therapy , Osteoporotic Fractures/diagnosis , Osteoporotic Fractures/therapy , Germany , Humans , Malpractice , Osteoporosis/etiology , Osteoporotic Fractures/complicationsABSTRACT
In pediatric traumatology as in any other surgical specialty, every treatment measure has to be protected by an adequate clarification. A legally effective clarification has to cover various aspects, such as diagnosis, treatment, risk and safety clarification and leads to an informed consent consultation. The contents of this informed consent discussion must be documented. The nature and extent of clarification, among other things depend on the urgency of the procedure and in an emergency it can be dispensed with in pediatric traumatology. In the case of minors the conversation must be conducted basically in the presence of both parents as they alone are legally entitled to give approval. General treatment proxies are not allowed. If it is not possible to talk to both parents the physician is allowed to trust that the parent present represents the will of the absent parent. Intervention cannot be carried out against the will of adolescents capable of self-determination even with the consent of the parents. The application of these rules is illustrated by means of practical examples.
Subject(s)
Informed Consent , Patient Safety , Pediatrics/organization & administration , Physician-Patient Relations , Referral and Consultation/organization & administration , Safety Management/organization & administration , Traumatology/organization & administration , Germany , Patient Education as Topic/organization & administrationABSTRACT
Up to approximately 15-20 years ago it could be safely assumed that the promotion to senior consultant surgeon was a lifetime position. Nowadays it is different. Contracts for senior consultants are normally for an unlimited period but as with other employees there is the possibility to legally terminate the employment conditions and approximately 50% make use of this. The reasons very rarely concern an inability of the physician and are mostly concerned with the surrounding working conditions. Poor contractual structures, incompatibility in the spectrum of responsibilities, financial restrictions by the finance department and poor communication with the finance department and colleagues are the main problem areas. In this article the potential points of conflict are demonstrated.
Subject(s)
Consultants/legislation & jurisprudence , Contracts/legislation & jurisprudence , Employment/legislation & jurisprudence , General Surgery/legislation & jurisprudence , National Health Programs/legislation & jurisprudence , Physician Executives/legislation & jurisprudence , Clinical Competence/legislation & jurisprudence , Germany , Humans , Job SatisfactionABSTRACT
Every medical intervention constitutes a physical injury and therefore requires the consent of the patient to avoid liability. In order that the patient can effectively consent to the intervention by ensuring autonomy of decision, the patient must be fully informed of the risks involved in medical interventions. The patient must be informed of the essential benchmark data however, it must be borne in mind that each individual case is always decisive for deciding whether clarification has been correctly carried out. In these instances individual factors, such as the personal background of the patient, play a role. Documentation of the clarification serves as proof that it has been carried out and to what extent.
