Medical mistakes and their absence in medical schools

Medical mistakes are any unintentional acts which are detrimental to patients' health, most of which have multiple causes or arise from the complexity of modern healthcare systems. Since no medical specialty is free of mistakes, training is needed beginning in undergraduate school to learn how to deal with them. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2522).

Medical negligence subject to criminal law.

OBJECTIVE: Introduction: Legal liability for medical negligence should contribute to the protection of patients' rights to life and health. At the same time, unreasonably strict sanctions against physicians should be analyzed much closely. More balanced model of such liability requires serious in-depth research. The aim of the article is to stimulate discussion about the necessity to improve the criminal legislation and judicial practice of criminal liability execution. PATIENTS AND METHODS: Materials and methods: This study is based on the analysis of international law, WHO documents, jurdicial practice and statistics, criminal and medical law legal doctrine (29 laws and papers, 97 court judgments were analyzed). Dialectical, comparative, analytic, synthetic and system analysis research methods were used, also for interpretation purposes. CONCLUSION: Conclusions: An effective legal mechanism should ensure the timeliness and thoroughness of the investigation and prosecution of each case of medical negligence to prevent the recurrence of such consequences in the future. Legal liability (civil, disciplinary or criminal) for medical negligence is a necessary part of this mechanism. The inevitability of criminal punishment rather than its severity should be recognized as a core for the medical negligence prevention concept. That's why the long-term imprisonment for medical negligence as a form of punishment should be recognized as socially unreasonable, it cannot improve the protection of patients' life and health but leads to significant negative social complications instead.

Estrés emocional en estudiantes de Medicina de la Universidad Nacional Autónoma de México / Emotional stress in medical students from the National Autonomous University of Mexico

El presente estudio se realizó con el objetivo de evaluar el impacto del estrés emocional en la adecuada toma de decisiones y práctica médica oportuna y de calidad de los estudiantes que cursan el quinto año de la carrera en la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM). Se utilizó una lista de valoración para las competencias de la simulación de reanimación cardiopulmonar avanzada, y un Cuestionario de Maslach Burnout Inventory (MBI) para valorar los sentimientos, actitudes y de desgaste profesional. Los resultados muestran que aquellos que estaban expuestos a mayor cantidad de labores recientes y estrés fueron más propensos de incidir en errores médicos durante la toma de decisiones y su aprendizaje.

This study was conducted with the aim of assessing the impact of emotional stress in the appropriate decision-making and quality medical practice of fifth year medical students from the Faculty of Medicine of the National Autonomous University of Mexico (UNAM). It was used an assessment list for cardiopulmonary resuscitation simulation competence and a Maslach Burnout Inventory (MBI) Questionnaire was used to assess feelings, attitudes and professional wear and tear. Results show those who were exposed to a greater number of recent tasks and to greater stress were more likely to make medical mistakes while making decisions and learning.

[Giving medico-legal opinions in cases with suspicion of medical mistake. part 2. Expert evidence in cases with suspicion of medical mistake - expectations, possibilities, threats ].

Problems of medical mistake and therapeutic failure are inextricably linked with realization of medical services. In recent years, mostly by the media and increasing demanding attitude, a rapid increase of initiated cases opened by judicial body in conjunction with medical mistake made by medical staff is observed. Making medico-legal opinions is not easy task and often face many difficulties. These consist of lacks in medical documentation, time rigor, formal tightening and need to create team that consist of both forensic medicine specialist and clinicians, who together shall write complex medico-legal opinion. This article touches the essence of the opinion-making problem in the aspect of medical mistake. It shows specifics of the role of forensic medicine specialist, his challenges and difficulties in creating opinions. The article confronts real possibilities of court experts with expectations of judicial body, outlining new challenges and dangers which court experts have to face.

[Giving medico-legal opinions in cases with suspicion of medical mistake.part 1. between medicine and justice.]

Creating medico-legal opinion is a sophisticated investigative, analytical, decision-making and creative process. Forensic medicine specialist in cooperation with clinical medicine consultants, on the basis of evidence analysis, which was gathered during procedures and contained in the acts has to create an objective and essential opinion. This opinion is a vital, very important and irreplaceable proof in every case. Judicial body consults with forensic medicine specialist or specialists if there are circumstances for settlement of which there is a need of classified informations - art. 193 of Penalty Code. Forensic medicine specialists face many difficulties which may have effect on quality, positiveness of opinion, compliance with the deadline, increasing expectancy of judicial body or sides. It is very difficult to find clinical specialists which except their clinical knowledge have basic knowledge about law, the role and duties of an court expert. In this article we discuss creating-opinion problems, role and position of court expert in confrontation with expectations of judicial body and the Justice with particular emphasis on medical mistakes and assessment of medical proceedings. We show the complexity of creating of medical opinions, especially these institutional.

[New pediatric drug dosage aids. Improving patient safety]. / Neue Hilfsmittel zur Dosierung von Medikamenten im Kindesalter. Verbesserung der Patientensicherheit.

Dosing errors when administering medicine to children occur often and are due, e.g., to the commonly required dilution of the drugs, misjudgment of the patient's weight, confusion between drugs with similar names, and inadequate communication. Various aids (e.g., measuring tapes and dilution tables) have been designed to avoid mistakes to the greatest extent possible. In daily clinical practice, books and pocket cards are still used for rapid orientation. Use of smartphone-based apps continues to increase, whereby the user is ultimately responsible for their validity. In clinical practice, the simplest possible strategies should be used. A culture that encourages disclosure of errors is useful in order to optimize processes and avoid future errors.

Patterns of medical accidents and disputes in the orthodontic field in Korea.

The committee of admitted doctors developed a questionnaire regarding medical dispute and distributed it to 1,600 members of Korean Academy of Orthodontics. The questionnaire consisted of three categories and 56 items covering basic information about the doctors and patients who had experienced medical disputes, the cause and workaround of medical accidents, and methods for taking precautions. The present survey showed a similar proportion of responders who had experienced a medical accident compared to the study in 1997. The primary reason for medical disputes was dissatisfaction with appearance. Many doctors felt that they would likely experience a medical dispute at some point. Most disputes were settled by doctors themselves, usually for an amount of less than 5 million Korean won. For some doctors, medical accidents lead to ongoing psychological problems. Responders felt that continuing education for medical dispute is very necessary. These results reveal a need for the association of orthodontists to lead advancements in education and countermeasures for preventing and managing medical accidents and disputes.

Patterns of medical accidents and disputes in the orthodontic field in Korea / 대한치과교정학회지

The committee of admitted doctors developed a questionnaire regarding medical dispute and distributed it to 1,600 members of Korean Academy of Orthodontics. The questionnaire consisted of three categories and 56 items covering basic information about the doctors and patients who had experienced medical disputes, the cause and workaround of medical accidents, and methods for taking precautions. The present survey showed a similar proportion of responders who had experienced a medical accident compared to the study in 1997. The primary reason for medical disputes was dissatisfaction with appearance. Many doctors felt that they would likely experience a medical dispute at some point. Most disputes were settled by doctors themselves, usually for an amount of less than 5 million Korean won. For some doctors, medical accidents lead to ongoing psychological problems. Responders felt that continuing education for medical dispute is very necessary. These results reveal a need for the association of orthodontists to lead advancements in education and countermeasures for preventing and managing medical accidents and disputes.

Application Research of Using Wireless Technology to Avoid Medical Mistake / 医疗卫生装备

Objective To avoid medical mistake,improve service quality of medical care,insure the security of patients. Methods The wireless Lan was deployed in ward to implement the scheme of using wireless Lan and avoid medical mistake,and then use wireless nursing system to prove it. Results This scheme can reduce the work intensity of medical staff,decrease the probability of medical mistake,and improve the service quality of medical care. Conclusion The wireless technology can avoid medical mistake effectively.