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

Korean Journal of Orthodontics (Impact Factor: 1.17). 01/2014; 44(1):5-12. DOI: 10.4041/kjod.2014.44.1.5
Source: PubMed


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.

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    • "From a technical scope, the intraoral wire cutting using flat nozzle pliers configures dangerous procedure, culminating in negligence due to clinical carelessness. According to Kim and Hwang [4], 2014, professional carelessness is the main cause of legal suits in the orthodontic environment from the patients' point of view. In general, carelessness comprehends a broad range of situations, such as accidental clinical malpractice. "
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    ABSTRACT: Purpose: The present study aims to report the first case of accidental perforation of the buccal mucosa caused by intraoral cutting of orthodontic wire. Case report: A 25-year-old female patient underwent an orthodontic consultation for treatment maintenance. During the procedure, the orthodontist performed an intraoral cutting of the distal portion of the orthodontic wire using flat nozzle pliers. The cut portion was projected, immediately perforating the buccal mucosa. Five days later, the patient became symptomatic. A successfully surgical retrieval was performed by a maxillofacial surgeon.Conclusion: The present case report stresses the relevance of following proper orthodontic techniques, highlighting the bioethical and legal aspects in the orthodontic clinical practice
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    ABSTRACT: Using the Korean Society of Anesthesiologists database of anesthesia-related medical disputes (July 2009-June 2014), causative mechanisms and injury patterns were analyzed. In total, 105 cases were analyzed. Most patients were aged < 60 yr (82.9%) and were classified as American Society of Anesthesiologists physical status ≤ II (90.5%). In 42.9% of all cases, the injuries were determined to be 'avoidable' if the appropriate standard of care had been applied. Sedation was the sec most common type of anesthesia (37.1% of all cases), following by general anesthesia. Most sedation cases (27/39, 69.2%) showed a common lack of vigilance: no pre-procedural testing (82.1%), absence of anesthesia record (89.7%), and non-use of intra-procedural monitoring (15.4%). Most sedation (92.3%) was provided simultaneously by the non-anesthesiologists who performed the procedures. After the resulting injuries were grouped into four categories (temporary, permanent/minor, permanent/major, and death), their causative mechanisms were analyzed in cases with permanent injuries (n=20) and death (n=82). A 'respiratory events' was the leading causative mechanism (56/102, 54.9%). Of these, the most common specific mechanism was hypoxia secondary to airway obstruction or respiratory depression (n=31). The sec most common damaging event was a 'cardiovascular events' (26/102, 25.5%), in which myocardial infarction was the most common specific mechanism (n=12). Our database analysis demonstrated several typical injury profiles (a lack of vigilance in seemingly safe procedures or sedation, non-compliance with the airway management guidelines, and the prevalence of myocardial infarction) and can be helpful to improve patient safety.
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