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J.Jpn. Surg. Soc.. 115(4): 231-235, 2014


Special contribution

DISEASES AND PROCEDURES APT TO CONFLICT WITH PATIENTS: AN ANALYSIS OF MEDICAL MALPRACTICE LITIGATION CASES

Department of Corpotrate Planning, Kanazawa University Hospital and Junko Echigo Law Office, Kanazawa, Japan

Junko Echigo

The aim of this study was to explore effective ways to prevent conflicts between patients and healthcare professionals by analyzing 836 malpractice cases.
The analysis revealed two points that especially influence court decisions: disease prognosis and inadequate informed consent. Regarding prognosis, decisions are more in favor of the defendant (medical institution) in diseases with poor prognoses, such as sepsis and anaphylaxis, than in diseases with typically good prognoses, such as acute epiglottitis and strangulation ileus.
Regarding insufficient informed consent, the cases fell into two groups, emergency and non-emergency. The non-emergency group consisted of cases such as preventative treatments for brain aneurysms and acute pancreatitis-related endoscopic retrograde cholangiopancreatography (ERCP), where essential information to consent to treatment, especially the prognosis with no treatment, was not given, despite sufficient time. The emergency group consisted of cases, such as acute coronary syndrome, especially treated by percutaneous coronary intervention (PCI), where there was not sufficient time to provide to patients information about treatments. This is the most difficult type of case and a subject for future efforts at clinical sites.


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