RESUMO
We received 50 claims of medical negligence in pediatric cardiology. From the analysis, patterns were identified and recommendations for improvement were found that apply generally to healthcare. Less than half (38%) of the claims were found to be medically meritorious. The impression of substandard care was often (7/50) created by an erroneous attribution of cause of death at autopsy. Both structured learning for caregivers and education of the public will reduce the frequency of malpractice forms-both valid and frivolous. Caregivers should document more effectively. The current tort system neither deters nor compensates as it was intended. The assignment of blame to a single individual is usually not in concert with the reality of modern medicine. Good health care is not a passive behavior; active participation by the public is required.
Assuntos
Procedimentos Cirúrgicos Cardíacos/legislação & jurisprudência , Cardiologia/legislação & jurisprudência , Competência Clínica , Imperícia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Pediatria/legislação & jurisprudência , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/métodos , Cardiologia/normas , Cardiologia/estatística & dados numéricos , Causas de Morte , Criança , Pré-Escolar , Coleta de Dados , Feminino , Humanos , Doença Iatrogênica/epidemiologia , Lactente , Formulário de Reclamação de Seguro/estatística & dados numéricos , Masculino , Prontuários Médicos/normas , Pediatria/normas , Pediatria/estatística & dados numéricos , Qualidade da Assistência à Saúde/legislação & jurisprudência , Gestão de Riscos , Estados UnidosRESUMO
The physician-patient relationship establishes a cause of action for malpractice should the physician breach his duty to the patient. Employer-contracted physical examinations create a professional relationship between physician and employee to the extent of the tests conducted. An Independent Medical Examination may create a professional relationship between the physician and subject of the Independent Medical Examination.
Assuntos
Responsabilidade Legal , Imperícia/legislação & jurisprudência , Relações Médico-Paciente , Humanos , Louisiana , Estados UnidosRESUMO
Seven cases are presented to illustrate four cervical surgical approaches to the upper mediastinum and thorax. These surgical approaches are described and illustrated, and we have termed these the retrosternal, retroclavicular, posterior, and lateral approaches. Two cases of thymic cyst, one of recurrent metastatic pretracheal adenopathy, a case of tracheal stenosis, a foreign body of the left subclavian artery, a large Zenker's diverticulum, and a neoglottic reconstruction are presented to illustrate the surgical anatomy, dissection technique, and postoperative complications.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Adolescente , Idoso , Pré-Escolar , Feminino , Humanos , Masculino , Cisto Mediastínico/cirurgia , Métodos , Pessoa de Meia-Idade , Neoplasias da Traqueia/cirurgia , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgia , Traqueotomia/efeitos adversosRESUMO
The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck is presented. It represents the seventh case to occur in the base of tongue and the second to be associated with pregnancy. The average age of onset is in the second decade with a 2:1 female preponderance and a marked tendency to right-sided occurrence. Treatment with surgery and/or radiotherapy is not curative. Local recurrence is common as are distant metastases, usually to lung, brain or bone. Theoretically, chemotherapy may offer better control of disease but few agents have shown dramatic response. The characteristics of the tumors are discussed and various chemotherapeutic agents are reviewed.
