RESUMEN
The causes and outcomes of medico-legal claims following amputation were evaluated. A retrospective analysis of the experience of a consultant surgeon acting as an expert witness within the United Kingdom and Ireland (1990-2010). There were 154 claims referred for an opinion of which 53 related to female patients. The median age was 67 (range, 20-101) years. Forty nine (32%) of the patients were known diabetics. Seventy-eight (51%) of the claims actually arose following a medically expected amputation, i.e. an amputation that was not preventable or due to negligence. The other common causes of claims were a delay in the diagnosis and or treatment of arterial ischaemia (34%), and following iatrogenic injuries (5%). Eleven of the claims are still ongoing, 3 went to trial, 52 (34%) were settled out of court and 83 (54%) were discontinued after the claimants were advised that they were unlikely to win their case. Disclosed settlement amounts are reported. Delays in the diagnosis and or treatment of arterial ischaemia were the commonest reasons that a claimant was successful. Half of claims did not proceed but were not without financial and psychological costs.
Asunto(s)
Amputación Quirúrgica/legislación & jurisprudencia , Mala Praxis/legislación & jurisprudencia , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Tardío , Femenino , Humanos , Enfermedad Iatrogénica , Irlanda , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tiempo de Tratamiento , Reino Unido , Tromboembolia Venosa/cirugía , Adulto JovenRESUMEN
INTRODUCTION: The causes and outcomes of medicolegal claims following laparoscopic cholecystectomy were evaluated. SUBJECTS AND METHODS: A retrospective analysis of the experience of a consultant surgeon acting as an expert witness within the UK and Ireland (1990-2007). RESULTS: A total of 151 claims were referred for an opinion. Sixty-three related to bile duct injuries and four followed major vascular injury. Bowel injury resulted in 17 claims. A postoperative biliary leak not associated with a bile duct injury was responsible for 25 claims. Other reasons for claims included spilled gallstones, port-site herniae, haemorrhage and other recognised complications associated with laparoscopic cholecystectomy. Twelve of the claims are on-going, two went to trial, 79 (52%) were settled out of court and 58 (38%) were discontinued after the claimants were advised that they were unlikely to win their case. Disclosed settlement amounts are reported. CONCLUSIONS: Bile duct and major vascular injuries are almost indefensible. The delay in diagnosis and (mis)management of other recognised complications following laparoscopic cholecystectomy have also led to a significant number of successful medicolegal claims.