Medical malpractice litigation related to gastrointestinal endoscopy in Japan: a two-decade review of civil court cases. 2006

Toru Hiyama, and Shinji Tanaka, and Masaharu Yoshihara, and Tatsuma Fukuhara, and Shinichi Mukai, and Kazuaki Chayama
Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan. tohiyama@hiroshima-u.ac.jp

OBJECTIVE To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to esophagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSIONS These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.

UI MeSH Term Description Entries
D007564 Japan A country in eastern Asia, island chain between the North Pacific Ocean and the Sea of Japan, east of the Korean Peninsula. The capital is Tokyo. Bonin Islands
D008318 Malpractice Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed) Professional Negligence,Negligence,Negligence, Professional,Professional Negligences
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012308 Risk Management The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed) Hospital Incident Reporting,Incident Reporting, Hospital,Hospital Incident Reportings,Incident Reporting,Incident Reportings, Hospital,Management, Risks,Reporting, Hospital Incident,Reportings, Hospital Risk,Voluntary Patient Safety Event Reporting,Hospital Risk Reporting,Hospital Risk Reportings,Incident Reportings,Management, Risk,Reporting, Hospital Risk,Reporting, Incident,Reportings, Hospital Incident,Reportings, Incident,Risk Reporting, Hospital,Risk Reportings, Hospital,Risks Management
D016099 Endoscopy, Gastrointestinal Endoscopic examination, therapy or surgery of the gastrointestinal tract. Endoscopic Gastrointestinal Surgical Procedures,Surgical Procedures, Endoscopic Gastrointestinal,Endoscopic Gastrointestinal Surgery,Gastrointestinal Endoscopic Surgical Procedures,Procedure, Endoscopic Gastrointestinal, Surgical,Procedure, Gastrointestinal Endoscopic Surgical,Procedures, Endoscopic Gastrointestinal, Surgical,Procedures, Gastrointestinal Endoscopic Surgical,Surgical Procedure, Endoscopic Gastrointestinal,Endoscopic Gastrointestinal Surgeries,Endoscopies, Gastrointestinal,Gastrointestinal Endoscopies,Gastrointestinal Endoscopy,Gastrointestinal Surgeries, Endoscopic,Gastrointestinal Surgery, Endoscopic,Surgeries, Endoscopic Gastrointestinal,Surgery, Endoscopic Gastrointestinal
D019300 Medical Errors Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent. Medical Mistakes,Surgical Errors,Critical Incidents, Medical,Critical Medical Incidents,Errors, Medical,Errors, Surgical,Medical Error of Commission,Medical Error of Omission,Medical Errors of Commission,Medical Errors of Omission,Medical Mistake,Mistake, Medical,Mistakes, Medical,Never Event,Surgical Error,Wrong-Patient Surgery,Wrong-Procedure Errors,Wrong-Site Surgery,Commission Medical Error,Commission Medical Errors,Critical Incident, Medical,Critical Medical Incident,Error, Medical,Error, Surgical,Error, Wrong-Procedure,Errors, Wrong-Procedure,Event, Never,Events, Never,Incident, Critical Medical,Incident, Medical Critical,Incidents, Critical Medical,Incidents, Medical Critical,Medical Critical Incident,Medical Critical Incidents,Medical Error,Medical Incident, Critical,Medical Incidents, Critical,Never Events,Omission Medical Error,Omission Medical Errors,Surgeries, Wrong-Patient,Surgeries, Wrong-Site,Surgery, Wrong-Patient,Surgery, Wrong-Site,Wrong Patient Surgery,Wrong Procedure Errors,Wrong Site Surgery,Wrong-Patient Surgeries,Wrong-Procedure Error,Wrong-Site Surgeries

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