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La exigencia de responsabilidad jurídica a los profesionales de la salud ha experimentado, a pesar de su antigüedad, un auge en las sociedades contemporáneas. En el artículo se reflexiona sobre conceptos médicos y jurídicos que permitan clarificar los presupuestos de intervención del Derecho en el ámbito de la Medicina, en función de la determinación de la responsabilidad médica jurídicamente relevante(AU)

In spite of being demanded since long ago, legal responsibility from health professionals has experienced a boom in contemporary societies. This article reflects on medical and legal concepts that make it possible to clarify the assumptions for involving law in the field of medicine, based on the determination of legally relevant medical responsibility(AU)

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This article examines the activities of a well-known figure who, during his stay in Argentina, influenced life in Buenos Aires by cultivating his connections to medical science, the political sphere and the news media. The person in question was Fernando Asuero, an ear, nose and throat specialist from San Sebastián (Spain), whose activities in Buenos Aires in 1930 allow us to examine the conflicts within the healing arts, a field rife with competitors and numerous concurrent and opposing traditions. Using a biographical approach centered on a case study, this article shows that, at certain points, the disputes over cognitive monopoly ended up being debated within a courtroom.

Indagamos el derrotero de un personaje que, durante su estadía en Argentina, incidió en la vida porteña mediante los vínculos que trazó con la ciencia galénica, la esfera política y los medios de comunicación. Nos referimos a Fernando Asuero, especialista en nariz, garganta y oídos, oriundo de San Sebastián (España), figura cuyo itinerario por Buenos Aires en 1930 nos permite avizorar enfrentamientos propios del arte de curar, campo minado de competidores y cuantiosas tradiciones concomitantes y contrapuestas. A partir de una aproximación biográfica centrada en un estudio de caso mostraremos que, en ciertas oportunidades, los litigios imbricados al monopolio cognitivo terminaron por debatirse en el interior de un juzgado.

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Las demandas por malpraxis en odontología se han incrementado en los últimos años, siendo la implantología una de las especialidades más litigadas. Estas demandas en su mayoría se han caracterizado por tener un carácter multifactorial, con errores reportados en cualquiera de sus fases diagnósticas, terapéuticas o de mantenimiento. El propósito de esta revisión fue establecer la etapa del tratamiento implantológico en la que más se realizaron demandas por malpraxis, estableciendo una categorización de los errores detectados y de los daños asociados a cada una de las fases que incluye el tratamiento de rehabilitación mediante implantes dentales. Se realizó una revisión con búsqueda sistemática de los últimos 10 años en las bases Pubmed, Scopus, Web of Science, SciELO, complementada con una búsqueda manual en revistas especializadas y en Google Scholar de artículos a partir de términos clave en idiomas español inglés y portugués. Se identificaron solo 3 artículos que cumplieron los criterios de selección, lo que afirma el concepto de escasa atención hacia esta eventualidad. Las demandas identificadas en esos reportes fueron analizadas sobre cuatro tipos de riesgo en implantología según la etapa del tratamiento en la que aparecen. La etapa quirúrgica fue identificada como la de mayor potencial de riesgo de originar eventos adversos y demandas asociadas. Se sugiere profundizar en los aspectos medicolegales propios y genéricos de la especialidad, como así también en el desarrollo de estrategias que prevengan sus eventos adversos y la judicialización asociada.

Dental malpractice claims have increased in recent years, and implantology is one of the most litigated specialties. Most of these claims have been characterized by having a multifactorial nature, with errors reported in any of their diagnostic, therapeutic or maintenance phases. The purpose of this review was to establish the stage of implant treatment in which the most malpractice claims were made, establishing a categorization of the errors detected and damages associated with each of the phases that includes rehabilitation treatment using dental implants. A review was carried out with a systematic search of the last 10 years in Pubmed, Scopus, Web of Science and SciELO databases, complemented with a manual search in specialized journals and in Google Academic, of articles from key words in Spanish, English and Portuguese languages. Only 3 articles were identified that met the selection criteria, which affirms the concept of scant attention given to this eventuality. The claims identified in these reports were analyzed on four types of risk in implantology according to the stage of treatment in which they appear. The surgical stage was identified as the one with the highest risk potential of causing adverse events and associated demands. It is suggested to deepen the specific and generic medico-legal aspects of the specialty, as well as in the development of strategies to prevent adverse events and the associated litigation.

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Resumen Indagamos el derrotero de un personaje que, durante su estadía en Argentina, incidió en la vida porteña mediante los vínculos que trazó con la ciencia galénica, la esfera política y los medios de comunicación. Nos referimos a Fernando Asuero, especialista en nariz, garganta y oídos, oriundo de San Sebastián (España), figura cuyo itinerario por Buenos Aires en 1930 nos permite avizorar enfrentamientos propios del arte de curar, campo minado de competidores y cuantiosas tradiciones concomitantes y contrapuestas. A partir de una aproximación biográfica centrada en un estudio de caso mostraremos que, en ciertas oportunidades, los litigios imbricados al monopolio cognitivo terminaron por debatirse en el interior de un juzgado.

Abstract This article examines the activities of a well-known figure who, during his stay in Argentina, influenced life in Buenos Aires by cultivating his connections to medical science, the political sphere and the news media. The person in question was Fernando Asuero, an ear, nose and throat specialist from San Sebastián (Spain), whose activities in Buenos Aires in 1930 allow us to examine the conflicts within the healing arts, a field rife with competitors and numerous concurrent and opposing traditions. Using a biographical approach centered on a case study, this article shows that, at certain points, the disputes over cognitive monopoly ended up being debated within a courtroom.

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El consentimiento informado forma parte de los elementos que constituyen el expediente clínico. Por su importancia informativa sobre posibles riesgos y complicaciones inherentes al tratamiento a realizar, su elaboración resulta de vital importancia. Existen numerosas legislaciones y normatividades que regulan este notable documento; sin embargo, resulta alarmante que muchos profesionistas omiten su realización o lo elaboran erróneamente, poniéndolos en riesgo de sufrir problemas legales. Además, es una realidad que el consentimiento informado es un documento mal entendido por la mayoría de los profesionistas, pudiendo incurrir en numerosos errores por desconocimiento. El objetivo del presente artículo es informar al cirujano dentista sobre los verdaderos alcances del consentimiento informado con fundamento en la legislación vigente en México (AU)

Informed consent is part of the elements that make up the clinical record. Due to its informative importance on possible risks and complications inherent to the treatment to be carried out, its preparation is of vital importance. There are numerous laws and regulations that regulate this remarkable document, however, it is alarming that many professionals omit its elaboration or wrongly elaborate it, putting them at risk of suffering legal problems. In addition, it is a reality that informed consent is a document misunderstood by most professionals, and may incur numerous errors due to ignorance. The aim of this article is to inform the dental surgeon about the true scope of informed consent based on current legislation in Mexico (AU)

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OBJECTIVE: The aims of this study were to review malpractice litigations involving vesicovaginal and rectovaginal fistulas after elective hysterectomy for benign indications in the United States and identify the most common themes in allegations by the plaintiffs and defenses by the defendants. METHODS: Using the Lexis Nexis legal database, we searched for and reviewed all U.S. malpractice litigations pertinent to this question between 1970 and 2020. RESULTS: Out of 82 cases that were identified and reviewed, 17 cases met our inclusion and exclusion criteria. These cases were decided between 1973 and 2019. Nine cases involved total abdominal hysterectomies, 1 involved total laparoscopic hysterectomy (TLH), 1 involved total vaginal hysterectomy (TVH), and the rest were not specified. Fifteen cases involved vesicovaginal fistulas and 2 involved rectovaginal fistulas. Three cases were ruled in favor of the plaintiffs, with monetary compensation ranging from $250,000 to $753,722 (approximately $364,120 to $1.8 million when adjusted for inflation), whereas 14 cases were ruled in favor of the defending surgeons. Common allegations were negligence in 15 cases and lack of informed consent in 2 cases. Factors that strengthened the defendants' arguments were thorough documentation, informed consent, and prompt referral to specialists. Intraoperative cystoscopy may have benefited in some cases. CONCLUSIONS: Thorough documentation, informed consent, and prompt referral to specialists strengthened the defendants' legal arguments. Intraoperative cystoscopy may also be beneficial.

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Objective: To describe Civil Claims (CCs) related to the provision of dental care according to court rulings published on the website of the Chilean Judicial Power. Material and methods: Descriptive study of 62 CCs filed against dentists or dental clinics according to court rulings available on the website of the Chilean Judicial Power between the years 2011 ­ 2017, identified by court rulings using a keyword search. Data were tabulated and analyzed using EXCEL and Stata.15, through descriptive statistics, proportions comparison test, and Spearman's Rho test. Results: An increase in the number of CCs according to the 2011-2017 court rulings was observed. CCs were filed on average 27.5 months after the events occurred. Judicial processes lasted a mean of 27 months, and the Araucanía region accounted for the highest rate. The highest number of lawsuits were placed against male general dentists with a mean age of 44, filed by female patients with a mean age of 46. A total of 66.13% of the CCs were rejected by the court, and 33.87% were ruled in favor of the plaintiffs. The financial compensation claims reached an average of $37,751,516 CLP (1500.32 Chilean UF), approximately $47,000 USD as of the date of the data collection process. Conclusion: There is an upward trend in the filing of CCs in Chile, although most were rejected by the court. A better understanding of the reasons that lead to the legal processes is necessary to prevent their occurrence.

Objetivo: Describir los Reclamos Civiles (CC) relacionados con la prestación de atención odontológica según sentencias judiciales publicadas en el sitio web del Poder Judicial de Chile. Material y Métodos: Estudio descriptivo de 62 CC interpuestas contra dentistas o clínicas dentales según sentencias judiciales disponibles en el sitio web del Poder Judicial de Chile entre los años 2011 - 2017, identificadas por sentencias judiciales mediante búsqueda por palabra clave. Los datos se tabularon y analizaron mediante EXCEL y Stata.15, mediante estadística descriptiva, prueba de comparación de proporciones y prueba Rho de Spearman. Resultados: Se observó un aumento en el número de CC según las sentencias judiciales de 2011-2017. Los CC se presentaron en promedio 27,5 meses después de ocurridos los hechos. Los procesos judiciales duraron una media de 27 meses y la región de la Araucanía registró la tasa más alta. El mayor número de demandas se presentaron contra dentistas generales varones con una edad media de 44 años, interpuestas por pacientes mujeres con una edad media de 46 años. El 66,13% de las CC fueron rechazadas por el tribunal y el 33,87% falló a favor. de los demandantes. Los reclamos de compensación económica alcanzaron un promedio de $ 37.751.516 CLP (1500,32 UF chilenas), aproximadamente $ 47.000 USD a la fecha del proceso de recolección de datos. Conclusión: Existe una tendencia ascendente en la presentación de CC en Chile, aunque la mayoría fueron rechazadas por el tribunal. Es necesario comprender mejor las razones que conducen a los procesos legales para prevenir su ocurrencia.

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The increase in lawsuits against veterinarians based on recklessness, negligence and malpractice is a current trend since pets are increasingly viewed as part of the family, and legal action is sought if the owner is frustrated with the services rendered by the veterinarian. However, since scarce data exists on this issue, this study aims to quantify and qualify lawsuits filed against veterinarians in the state of São Paulo, Brazil to identify and correlate potential risk factors that may lead to conviction or acquittal of defendants. For this purpose, the methodology employed a search for lawsuits on the website of the São Paulo State Court of Justice, sorted by year; proceedings (summary or special civil court); plaintiff's claim (non-economic damages, economic damages, malpractice, negligence or recklessness); court decision (case granted or denied); reason for judgment (sufficient or insufficient evidence); reverse burden of proof (present or absent); type of evidence (deposition, documentary and expert testimony); value of damages claimed and awarded; location (greater São Paulo or inner state), and whether the lawsuit was filed against a veterinary clinic or hospital. These categories shed light, through bivariate and Poisson regression analyses, on the potential risk factors relative to court decisions. Results demonstrate that reverse burden of proof and insufficient evidence as the basis for judgment were, respectively, risk factors for conviction and acquittal of veterinary practitioners, and the number of lawsuits increased by 533 % over eight years.

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Resumo Objetivo: Caracterizar processos com decisões judiciais por erros envolvendo profissionais de enfermagem. Métodos: Estudo documental, com os casos julgados e concluídos, que versavam sobre erro envolvendo profissionais de enfermagem. O levantamento foi realizado nos meses de maio e junho de 2018, no sítio online do Tribunal de Justiça do Paraná. As informações de interesse foram: local da ocorrência, profissionais envolvidos, características das vítimas, do erro e o desfecho da investigação. Para análise os dados foram submetidos à estatística descritiva. Resultados: Foram identificados 31 casos julgados, cuja maioria ocorreu em ambiente hospitalar (90,32%), com indivíduos adultos (64,71%). Em oito casos a vítima foi a óbito, em metade deles apresentou incapacidade temporária (17=50%) e sete pessoas apresentaram incapacidade permanente. O erro mais frequente envolveu a administração de medicamentos (38,71%), seguido por erro de assistência ao parto (19,35%). Em mais da metade dos casos o boletim de ocorrência foi registrado pela própria vítima (58,06%) e somente um perito médico foi consultado durante o processo (61,29%). Em 22 casos o profissional foi condenado. Destes, 20 foram condenações cíveis e duas criminais. Em média, os processos cíveis geraram ressarcimento de R$ 42.614,30 reais e nos processos criminais, a média de tempo de reclusão, convertidos em serviços comunitários foi de 18 meses. Conclusão: Os processos judiciais culminaram em condenações. Além disso, apontam à necessidade de melhor estrutura e apoio aos profissionais que passam pela experiência jurídica.

Resumen Objetivo: Caracterizar procesos con decisiones judiciales por errores donde hubo profesionales de enfermería involucrados. Métodos: Estudio documental con los casos juzgados y concluidos, referentes a errores donde hubo profesionales de enfermería involucrados. El análisis fue realizado en los meses de mayo y junio de 2018, en el sitio web del Tribunal de Justicia de Paraná. La información de interés obtenida fue: lugar del caso, profesionales involucrados, características de las víctimas y del error y desenlace de la investigación. Los datos fueron sometidos a la estadística descriptiva para su análisis. Resultados: Se identificaron 31 casos juzgados, cuya mayoría ocurrió en ambiente hospitalario (90,32%), con individuos adultos (64,71%). En 8 casos la víctima falleció, en la mitad de los casos la persona presentó incapacidad temporaria (17=50%) y 7 personas presentaron incapacidad permanente. El error más frecuente se relacionó con la administración de medicamentos (38,71%), seguido por error de atención en el parto (19,35%). En más de la mitad de los casos, la denuncia fue registrada por la propia víctima (58,06%) y se consultó solo a un perito médico durante el proceso (61,29%). En 22 casos el profesional fue condenado, de los cuales 20 fueron sentencias civiles y dos criminales. En promedio, los procesos civiles generaron indemnizaciones de R$ 42.614,30 y en los procesos criminales, el promedio de tiempo de reclusión, convertidos en servicios comunitarios, fue de 18 meses. Conclusión: Los procesos judiciales terminaron en sentencias. Además, señalan la necesidad de una mejor estructura y apoyo a los profesionales que pasan por la experiencia jurídica.

Abstract Objective: To characterize lawsuits with judicial decisions by errors involving nursing professionals. Methods: A documentary study, with cases judged and concluded that dealt with error involving nursing professionals. The survey was carried out in May and June 2018, on the online website of the Court of Justice of Paraná State. The information of interest was place of occurrence, professionals involved, characteristics of victims, error and outcome of the investigation. For analysis, the data were submitted to descriptive statistics. Results: There were 31 cases judged, most of which occurred in a hospital (90.32%) and with adults (64.71%). In eight cases, the victim died; in half, the victims had temporary disability (17.50%); seven people had permanent disability. The most frequent error involved medication administration (38.71%), followed by delivery error (19.35%). In more than half of the cases, police report card was registered by the victim (58.06%) and only one medical expert was consulted during the lawsuit (61.29%). In 22 cases, the professional was convicted. Of these, 20 were civil and two criminal convictions. On average, civil lawsuits generated reimbursement of about 10,654 US dollars. In criminal cases, the average length of imprisonment converted into community services was 18 months. Conclusion: Lawsuits culminated in convictions. In addition, they point to the need for better structure and support for professionals who undergo legal experience.

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RESUMEN: El objetivo de este trabajo fue analizar los datos epidemiológicos y jurídicos de los casos por responsabilidad médica fallados por la Corte Suprema de Justicia chilena (CSJ) el año 2017, para relevar los escenarios de alto riesgo, aportando a su prevención. Se realizó un estudio retrospectivo, revisando los fallos de la CSJ en la base de datos electrónica del Poder Judicial chileno. Se seleccionaron y analizaron los fallos por responsabilidad médica. Se detectó un total de 61 casos por responsabilidad médica que alcanzaron la CSJ en 2017. Todos correspondieron a causas civiles. La duración promedio de los juicios fue 41,9 meses. La especialidad más demandada y condenada fue ginecología. La mayoría de las demandas y condenas afectó al Sistema Público de salud. Los casos que dan origen a las demandas son, en su mayoría, de atención de urgencias por sobre las programadas, y de tratamiento por sobre procedimientos quirúrgicos. El 54,8 % de los casos resultaron en la muerte del paciente. La mitad de los fallos condenatorios involucraba el fallecimiento del usuario afectado. Se deben investigar los factores de riesgo no sólo de la ocurrencia de mal-praxis, si no de la judicialización de los conflictos médico-paciente, especialmente en el área gineco-obstétrica, incluyendo los casos de instancias anteriores a la CSJ. Se debe investigar así mismo los factores de riesgo para la mayor propensión de los profesionales de sexo masculino de ser demandados y condenados por malpraxis médica.

ABSTRACT: The objective of the present study is to characterize the epidemiologic and juridical data for medical malpractice cases ruled by the Chilean Supreme Court (CSC) in 2017, to highlight the high risk scenarios, as a contribution to their prevention. A search of the CSC electronic database was conducted to identify and analyze CSC rulings for medical malpractice cases. In this study 61 malpractice cases ruled by CSC were identified. The CSC received only civil cases of medical malpractices during the studied period. The average duration of the trial was 41.9 months. Gynecologists faced suits and received sentences more frequently than any other type of specialist. The majority of prosecuted cases and convictions were associated with the public health system. A greater number of claims were related to emergency care than with scheduled procedures. Likewise, more claims were associated with non-surgical treatment than with surgical procedures. 54.8 % of all cases resulted in the patient's death. Half of the cases that lead to conviction, were related to the death of a patient. Risk factors should be investigated, not only of the occurrence of malpractice, but also of the judicial process of doctor-patient conflicts, especially in the obstetrics and gynecology area, including the analysis of cases of prior judicial instances. The risk factors for the higher propensity of male professionals to be prosecuted and convicted for medical malpractice should also be investigated.

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The purpose of expert reports is to support the judge in his decisions, by providing technical information. However, it remains uncertain as to what extent the content of these reports is used, and if they are effectively associated with judicial decisions. The aim of this study was to perform a qualitative analysis of case reports in relation to the judicial decisions rendered in association with these reports, by determining the connection between causal nexus and aspects of fault. The case reports included lawsuits against dentists, issued by the Medical Justice Department of the State Court of Appeals of Rio Grande do Sul, Brazil, between 2010 and 2013. Comparing the percentage of agreement between case report and judicial decision, causal nexus was 79.9% and fault was 86.7%. The high percentages of agreement found in relation to fault and causal nexus highlight the relevance of expert reports in weighing the judge's decision.

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Negligent conduct by health care providers can result in medical malpractice injury sustained by parents denied their right to decide whether and when to have children. In this review of the international medicolegal literature, the authors present a comparative analysis of the law of medical negligence in this context and a discussion of the grounds for compensable injury resulting from medical error. The discussion is focused on the legal provisions for compensable injury awarded to the plaintiff (expectant mother, parents of the born child, and born child) and the types of injury various legal systems recognize in such cases. The aim of this article is to provide medical malpractice investigators and legal professionals with an overview of the birth cases.

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Introduction The objective of the present study was to review the epidemiological aspects of malpractice in neurosurgery and to identify preventive measures regarding malpractice for neurosurgeons. Methods The following terms (alone or in combination) were searched in the PubMed and Biblioteca Virtual em Saúde databases: neurosurgery (neurocirurgia), lawsuits (ações judiciais), malpractice (erro médico), and litigation (litígio) and identifying studies on these topics published from 2000 to April 2018. Literature Review In Brazil, 6.9% of the physicians are sued per year. The most common type of malpractice alleged in litigation is negligence. According to the literature, the neurosurgical disease that has sparked the most litigation is spinal disease. The outcomes of these cases vary: sometimes the neurosurgeon prevails, and at other times the plaintiff prevails. To prevent or reduce malpractice claims, the neurosurgeon should take the following precautions: 1. follow medical protocols; 2. perform surgeries in an environment consistent with good medical practice; 3. evaluate and monitor antibiotic prophylaxis; 4. develop a good relationship with the patient based on ethics, good faith and transparency; 5. request the presence of the patient and of his or her family when there is a problem in order to didactically explain the case; 6. keep good medical records to document all of the actions performed (informed consent and description of the surgery and of the pre and postoperative); 7. always seek technical improvement (continuing education/professional development); 8. in the case of attending physicians, monitor patients, treating any postoperative complications; and 9. conduct multidisciplinary team meetings to optimize treatment decisions and to share responsibility for making difficult decisions.

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OBJECTIVE: the present study aimed at evaluating the risks and vulnerability of orthodontists to legal compensation actions and verifying the hypothesis of these health care professionals having little knowledge concerning their rights and obligations as service providers. METHODS: Three groups were formed to participate in a semi-structured interview. The first group had thirteen law professionals, the second group was composed of eleven orthodontists and the third group was made up of nine randomly selected orthodontic patients. RESULTS: Relevant aspects related to the exercise of the professional activity of orthodontists that influence on the vulnerability of orthodontists in lawsuits were identified. After transcription, reading, and comparing the answers of the interviews, items capable of influencing judicial decisions, from the standpoint of Brazilian Justice Courts, were evaluated. CONCLUSION: It was verified that Brazilian orthodontists do not have adequate formation concerning the legal consequences of the exercise of their professional activity. Orthodontists also failed to establish proper contractual relationship, organize orthodontic records, and, most importantly, failed in communicating the risks and the therapeutic processes to patients during all phases of treatment.

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Under Chilean public law, liability of a public hospital appears when the institution fails to accomplish its mandatory duties or incurs in negligence. As in private law liability, this system requires to determine the duties of hospitals and, in case of a medical accident, professional standards or duties. This paper explores the two main categories of medical malpractice, namely erroneous diagnosis and treatment failures based on public law theory and judiciary methods.

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ABSTRACT Objective: the present study aimed at evaluating the risks and vulnerability of orthodontists to legal compensation actions and verifying the hypothesis of these health care professionals having little knowledge concerning their rights and obligations as service providers. Methods: Three groups were formed to participate in a semi-structured interview. The first group had thirteen law professionals, the second group was composed of eleven orthodontists and the third group was made up of nine randomly selected orthodontic patients. Results: Relevant aspects related to the exercise of the professional activity of orthodontists that influence on the vulnerability of orthodontists in lawsuits were identified. After transcription, reading, and comparing the answers of the interviews, items capable of influencing judicial decisions, from the standpoint of Brazilian Justice Courts, were evaluated. Conclusion: It was verified that Brazilian orthodontists do not have adequate formation concerning the legal consequences of the exercise of their professional activity. Orthodontists also failed to establish proper contractual relationship, organize orthodontic records, and, most importantly, failed in communicating the risks and the therapeutic processes to patients during all phases of treatment.

RESUMO Objetivo: o presente trabalho teve como objetivo apurar os riscos e a vulnerabilidade dos profissionais ortodontistas serem envolvidos em lides judiciais com finalidade indenizatória, além de verificar a hipótese de que esses profissionais possuem pouco conhecimento a respeito de suas obrigações e deveres como prestadores de serviço, bem como dos mecanismos que podem evitar tais demandas judiciais. Métodos: foram formados três grupos para entrevistas semiestruturadas, compostos por profissionais da área jurídica, profissionais ortodontistas e pacientes ortodônticos: no primeiro grupo, foram entrevistados 13 (treze) profissionais da área jurídica; no segundo grupo de entrevistados, foram abordados 11 (onze) profissionais ortodontistas; para o terceiro grupo de entrevistas, foram sorteados 9 (nove) pacientes em tratamento ortodôntico. Resultados: foram identificados itens ou domínios relevantes, relacionados ao exercício da atividade profissional dos ortodontistas, que repercutem diretamente em aspectos de vulnerabilidade deles, quando confrontados, objetivamente, com fundamentos de decisões judiciais envolvendo questões indenizatórias em face de tais profissionais da área da saúde. Após o trabalho de transcrição das entrevistas, leitura, compilação e comparação das respostas, passou-se à análise dos temas capazes de influenciar na rotina forense, a partir das tendências doutrinárias e jurisprudenciais encontradas nos Tribunais brasileiros. Conclusão: verificou-se que os ortodontistas não apresentam formação adequada para o completo entendimento sobre as consequências jurídicas do exercício de sua atividade profissional. Constataram-se, também, falhas por parte do profissional ortodontista, desde o estabelecimento da relação contratual, formação de documentação ortodôntica organizada e, sobretudo, registro, documentação e informação aos pacientes, ou responsáveis legais, em todas as etapas do tratamento.

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Resumen: Introducción: Las quejas constituyen un indicador negativo en la calidad de la atención médica. El conocimiento de los problemas que las originan y sus consecuencias constituyen elementos fundamentales para las estrategias de mejora de la calidad. En este estudio se dan a conocer los resultados del análisis de laudos concluidos, emitidos por la Comisión Nacional de Arbitraje Médico durante el periodo 2011-2015, que corresponden a la población usuaria menor de 15 años. Métodos: Estudio transversal descriptivo. Se analizó información extraída de los laudos concluidos en los últimos 5 años en los que la población afectada tuviera menos de 15 años, independientemente del servicio involucrado. Resultados: Se detectaron 40 laudos, la mayoría involucrados con servicios de pediatría, encontrándose una distribución homogénea por edad y sexo. Los porcentajes más altos se encontraron en las edades extremas de la población estudiada: menores de 1 año (32%) y de 10 a 14 años (30%). La principal causa de la queja fueron los problemas con los auxiliares de diagnóstico (45%). Se detectó un promedio de 8.7 eventos adversos por caso, la mayoría relacionados con procedimientos. Entre los daños destacan 12 defunciones y 9 discapacidades permanentes. Se encontró evidencia de mala práctica en el 65% de los casos y hubo una sentencia condenatoria en el 60% de los laudos. Conclusiones: Se obtuvieron resultados en cuatro grandes apartados: características sociodemográficas, descripción de la atención médica, eventos adversos y sus repercusiones en los daños a la salud, y la evaluación del acto médico y conclusiones del laudo.

Abstract: Background: Claims by health services users are a negative indicator of the care quality. To know the situations that originate them, and their consequences are key issues to consider in order to design strategies to improve the quality of health services. This study analyses the cases submitted to the National Medical Arbitration Commission with a final arbitration decision during the period 2011-2015, related to health service users younger than 15 years old. Methods: Cross-sectional descriptive study. We analyzed information extracted from the reports with a final arbitration decision in the last 5 years, selecting those where the affected users were younger than 15 years old. Results: A total of 40 cases arbitral award were found, most of them involving pediatric services, with a similar number of male and female users and a similar proportion in the extreme age groups, <1 year (32%) and 10-14 years (30%). The main cause of the complaint was related to diagnostic procedures (45%). An average of 8.7 adverse events per case were identified, most of them associated with procedures. Among the damages, there were 12 deaths and 9 permanent disabilities. There was evidence of malpractice in 65% of the cases and in 60% of the cases, the sentence was condemnatory. Conclusions: This manuscript shows information in four main sections: sociodemographic characteristics, description of medical care, adverse events and their repercussions on health damages, evaluation of the medical act and conclusions of the arbitration process.

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