[Gastroenterology - accusations and errors in treatment: evaluation of the completed expertise process in internal medicine of the expert committee of North Rhineland for the years 2001 to 2005].

Gutachterkommission, Arztekammer Nordrhein.
Zeitschrift für Gastroenterologie (Impact Factor: 1.05). 09/2008; 46(8):766-70.
Source: PubMed


Since three decades the extrajudical expertise procedures of the Expert Committee and Arbitration Group has served to pacify the doctor-patient relationship. Systematic analyses of accusations and errors provide valuable data that help to avoid treatment errors and liability disputes against physicians. Disease of the gastrointestinal tract were found ex post to be the main diagnosis in 10 % of the patients entering complaints. The most common benign diseases were bile duct diseases (1.5 %), acute appendicitis (1.2 %) and diverticulosis (0.9 %); malignant tumours of the digestive organs were found in 1.8 %. About one-third of the procedures were directed internists; with 25 % the quota of treatment errors was less than the general average of one third. With an overproportional frequency (56 %) diagnosis errors were confirmed for the occurrence of appendicitis. Diagnostic and therapeutic endoscopic examinations were the subject of the claimed erroneous treatment by internists in 34 % of the cases: perforations and postinterventional pancreatitis were frequent reasons for filing a complaint. For the resultant injuries, including 4 fatalities, the internists were found to be liable for damages in a total of 17 % of the cases.

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    ABSTRACT: BACKGROUND: The increasing number of patients taking action for medical malpractice (MM) is a burden for the medical practitioners accused. After the assessment through an arbitration committee, which is free of cost for the patients,a large number of lawsuits can be avoided. Discussion of patient complaints and analyzing cases of MM is an important concern for the medical community in order to reduce errors in treatment and to contribute to patient safety. MATERIAL AND METHODS: The patient applications to the arbitration committee of the medical association of North-Rhine ("Gutachterkommission Nordrhein") for review of MM in the field of ophthalmology in the years 1999-2010 were analyzed statistically. RESULTS: In the years 1999-2010 a total of 583 cases were related to ophthalmology (3% of all cases) and in 122 cases (21%) MM was recognized by the committee. In 61% of the cases MM was caused by errors in diagnosis, in 24% by errors in processes and in 15% by errors in surgical procedures. CONCLUSIONS: The proportion of ophthalmological cases in the total number of MM cases is low. Most errors in diagnosis are caused by the lack of basic diagnostic on examination procedures. Errors in processes are caused by instrumental errors and deficient communication. An important reason for errors in surgical procedures is a deficient management of complications. A standardized workflow of medical examinations and a quality management can help to avoid MM.
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