Medical malpractice: Difference between revisions

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According to the Harvard Medical Practice Study, "medical-malpractice litigation infrequently  compensates patients injured by medical negligence and rarely identifies, and  holds providers accountable for, substandard care."<ref name="pmid2057025">{{cite journal |author=Localio AR, Lawthers AG, Brennan TA, ''et al'' |title=Relation between malpractice claims and adverse events due to negligence. Results of the Harvard Medical Practice Study III |journal=N. Engl. J. Med. |volume=325 |issue=4 |pages=245–51 |year=1991 |pmid=2057025 |doi=}}</ref> In one study, one third of claims did not involve medical error.<ref name="pmid16687715">{{cite journal |author=Studdert DM, Mello MM, Gawande AA, ''et al'' |title=Claims, errors, and compensation payments in medical malpractice litigation |journal=N. Engl. J. Med. |volume=354 |issue=19 |pages=2024–33 |year=2006 |pmid=16687715 |doi=10.1056/NEJMsa054479}}</ref>
According to the Harvard Medical Practice Study, "medical-malpractice litigation infrequently  compensates patients injured by medical negligence and rarely identifies, and  holds providers accountable for, substandard care."<ref name="pmid2057025">{{cite journal |author=Localio AR, Lawthers AG, Brennan TA, ''et al'' |title=Relation between malpractice claims and adverse events due to negligence. Results of the Harvard Medical Practice Study III |journal=N. Engl. J. Med. |volume=325 |issue=4 |pages=245–51 |year=1991 |pmid=2057025 |doi=}}</ref> In one study, one third of claims did not involve medical error.<ref name="pmid16687715">{{cite journal |author=Studdert DM, Mello MM, Gawande AA, ''et al'' |title=Claims, errors, and compensation payments in medical malpractice litigation |journal=N. Engl. J. Med. |volume=354 |issue=19 |pages=2024–33 |year=2006 |pmid=16687715 |doi=10.1056/NEJMsa054479}}</ref>


==Expert testimony==
==Expert testimony and standard of care==
The legal system has focused on assessing the quality of the expert who interprets evidence for the court rather than the quality of the evidence itself. Methods to assess expertise have included the [[Frye test]] and the [[Daubert standard]].<ref name="urlExpertise in Law, Medicine, and Health Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/shuman2.htm |title=Expertise in Law, Medicine, and Health Care |author=Anonymous |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref><ref name="urlFrom the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/morreim2.htm |title=From the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care |author=Anonymous  |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref> Occasionally, courts have used "Daubert panels" to assess evidence in large tort claims.<ref name="pmid10717019">{{cite journal |author=Hulka BS ''et al.'' |title=Experience of a scientific panel formed to advise the federal judiciary on silicone breast implants |journal=N Engl J Med |volume=342 |pages=812–5 |year=2000 |month=March |pmid=10717019 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10717019&promo=ONFLNS19 |issn=}}</ref>
In the [[United States]], most states now try to determine what is the best medical practice. Originally, efforts focused on assessing the quality of the expert who interprets evidence for the court rather than the quality of the evidence itself. The [[Frye test]] helped determine who was expert. More recently, the [[Daubert standard]] is used to assess the quality of evidence.<ref name="urlExpertise in Law, Medicine, and Health Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/shuman2.htm |title=Expertise in Law, Medicine, and Health Care |author=Anonymous |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref><ref name="urlFrom the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/morreim2.htm |title=From the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care |author=Anonymous  |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref> Occasionally, courts have used "Daubert panels" to assess evidence in large tort claims.<ref name="pmid10717019">{{cite journal |author=Hulka BS ''et al.'' |title=Experience of a scientific panel formed to advise the federal judiciary on silicone breast implants |journal=N Engl J Med |volume=342 |pages=812–5 |year=2000 |month=March |pmid=10717019 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10717019&promo=ONFLNS19 |issn=}}</ref>


Some states also use a locality rule, or local standards of care despite ethical problems with this standard.<ref name="pmid17579232">{{cite journal |author=Lewis MH, Gohagan JK, Merenstein DJ |title=The locality rule and the physician's dilemma: local medical practices vs the national standard of care |journal=JAMA |volume=297 |issue=23 |pages=2633–7 |year=2007 |month=June |pmid=17579232 |doi=10.1001/jama.297.23.2633 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=17579232 |issn=}}</ref>, A well-publicized malpractice case of screening for [[prostate cancer]] was dtermined in this way.<ref name="pmid14709561">{{cite journal |author=Merenstein D |title=A piece of my mind. Winners and losers |journal=JAMA |volume=291 |issue=1 |pages=15–6 |year=2004 |month=January |pmid=14709561 |doi=10.1001/jama.291.1.15 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=14709561 |issn=}}</ref> This specific case has been associated with an increase in screening for prostate cancer.<ref name="pmid17389535">{{cite journal |author=Krist AH, Woolf SH, Johnson RE |title=How physicians approach prostate cancer screening before and after losing a lawsuit |journal=Ann Fam Med |volume=5 |issue=2 |pages=120–5 |year=2007 |pmid=17389535 |pmc=1838685 |doi= |url=http://www.annfammed.org/cgi/pmidlookup?view=long&pmid=17389535 |issn=}}</ref>
Some states also use a locality rule, or local standards of care despite ethical problems with this standard.<ref name="pmid17579232">{{cite journal |author=Lewis MH, Gohagan JK, Merenstein DJ |title=The locality rule and the physician's dilemma: local medical practices vs the national standard of care |journal=JAMA |volume=297 |issue=23 |pages=2633–7 |year=2007 |month=June |pmid=17579232 |doi=10.1001/jama.297.23.2633 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=17579232 |issn=}}</ref> The locality rule may "may inhibit the incorporation of scientific progress into practice standards."<ref name="pmid17579232"/>  A well-publicized malpractice case of screening for [[prostate cancer]] was dtermined in this way.<ref name="pmid14709561">{{cite journal |author=Merenstein D |title=A piece of my mind. Winners and losers |journal=JAMA |volume=291 |issue=1 |pages=15–6 |year=2004 |month=January |pmid=14709561 |doi=10.1001/jama.291.1.15 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=14709561 |issn=}}</ref> This specific case has been associated with an increase in screening for prostate cancer.<ref name="pmid17389535">{{cite journal |author=Krist AH, Woolf SH, Johnson RE |title=How physicians approach prostate cancer screening before and after losing a lawsuit |journal=Ann Fam Med |volume=5 |issue=2 |pages=120–5 |year=2007 |pmid=17389535 |pmc=1838685 |doi= |url=http://www.annfammed.org/cgi/pmidlookup?view=long&pmid=17389535 |issn=}}</ref>


Decision analysis has been proposed to improve the reliability of expert testimony.<ref name="pmid2231036">{{cite journal |author=Weir SS, Curtis P, McNutt RA |title=Expert testimony based on decision analysis: a malpractice case report |journal=J Gen Intern Med |volume=5 |issue=5 |pages=406–9 |year=1990 |pmid=2231036 |doi=}}</ref>
Decision analysis has been proposed to improve the reliability of expert testimony.<ref name="pmid2231036">{{cite journal |author=Weir SS, Curtis P, McNutt RA |title=Expert testimony based on decision analysis: a malpractice case report |journal=J Gen Intern Med |volume=5 |issue=5 |pages=406–9 |year=1990 |pmid=2231036 |doi=}}</ref>
==Standard of care==
The ''legal system'' uses various methods to interpret evidence. In the [[United States]], some states use a 'locality rule' in which there is no attempt to determine best medical practice, but rather the court ascertains what is the most common local practice.<ref name="pmid17579232">{{cite journal |author=Lewis MH, Gohagan JK, Merenstein DJ |title=The locality rule and the physician's dilemma: local medical practices vs the national standard of care |journal=JAMA |volume=297 |issue=23 |pages=2633–7 |year=2007 |month=June |pmid=17579232 |doi=10.1001/jama.297.23.2633 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=17579232 |issn=}}</ref> The locality rule may "may inhibit the incorporation of scientific progress into practice standards."<ref name="pmid17579232"/> 
Most states now try to determine what is the best medical practice. Originally, efforts focused on assessing the quality of the expert who interprets evidence for the court rather than the quality of the evidence itself. The [[Frye test]] helped determine who was expert. More recently, the [[Daubert standard]] is used to assess the quality of evidence.<ref name="urlExpertise in Law, Medicine, and Health Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/shuman2.htm |title=Expertise in Law, Medicine, and Health Care |author=Anonymous |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref><ref name="urlFrom the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care">{{cite web |url=http://www.ahrq.gov/clinic/jhppl/morreim2.htm |title=From the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care |author=Anonymous  |authorlink= |coauthors= |date= |format= |work= |publisher=U.S. Agency for Healthcare Research and Quality |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-01-15}}</ref> Occasionally, courts have used "Daubert panels" to assess evidence in large tort claims.<ref name="pmid10717019">{{cite journal |author=Hulka BS ''et al.'' |title=Experience of a scientific panel formed to advise the federal judiciary on silicone breast implants |journal=N Engl J Med |volume=342 |pages=812–5 |year=2000 |month=March |pmid=10717019 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10717019&promo=ONFLNS19 |issn=}}</ref>


States vary in their implementation of apology laws.<ref name="pmid19047028">{{cite journal |author=McDonnell WM, Guenther E |title=Narrative review: do state laws make it easier to say "I'm sorry?" |journal=Ann. Intern. Med. |volume=149 |issue=11 |pages=811–6 |year=2008 |month=December |pmid=19047028 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=19047028 |issn=}}</ref> Some states have laws that protect voluntary expressions of "sympathy, regret, and condolence" whereas other states protect "admissions of fault as well as expressions of sympathy."<ref name="pmid19047028"/>
States vary in their implementation of apology laws.<ref name="pmid19047028">{{cite journal |author=McDonnell WM, Guenther E |title=Narrative review: do state laws make it easier to say "I'm sorry?" |journal=Ann. Intern. Med. |volume=149 |issue=11 |pages=811–6 |year=2008 |month=December |pmid=19047028 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=19047028 |issn=}}</ref> Some states have laws that protect voluntary expressions of "sympathy, regret, and condolence" whereas other states protect "admissions of fault as well as expressions of sympathy."<ref name="pmid19047028"/>

Revision as of 19:46, 18 March 2009

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This editable Main Article is under development and subject to a disclaimer.

Medical malpractice is the "failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows".[1]

Epidemiology

Malpractice can occur in the inpatient setting, outpatient setting[2], and with telephone medicine.[3]

Relationship to medical error

For more information, see: medical error.

According to the Harvard Medical Practice Study, "medical-malpractice litigation infrequently compensates patients injured by medical negligence and rarely identifies, and holds providers accountable for, substandard care."[4] In one study, one third of claims did not involve medical error.[5]

Expert testimony and standard of care

In the United States, most states now try to determine what is the best medical practice. Originally, efforts focused on assessing the quality of the expert who interprets evidence for the court rather than the quality of the evidence itself. The Frye test helped determine who was expert. More recently, the Daubert standard is used to assess the quality of evidence.[6][7] Occasionally, courts have used "Daubert panels" to assess evidence in large tort claims.[8]

Some states also use a locality rule, or local standards of care despite ethical problems with this standard.[9] The locality rule may "may inhibit the incorporation of scientific progress into practice standards."[9] A well-publicized malpractice case of screening for prostate cancer was dtermined in this way.[10] This specific case has been associated with an increase in screening for prostate cancer.[11]

Decision analysis has been proposed to improve the reliability of expert testimony.[12]

States vary in their implementation of apology laws.[13] Some states have laws that protect voluntary expressions of "sympathy, regret, and condolence" whereas other states protect "admissions of fault as well as expressions of sympathy."[13]

References

  1. ↑ Anonymous (2024), term (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Gandhi TK, Kachalia A, Thomas EJ, et al (2006). "Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims". Ann. Intern. Med. 145 (7): 488–96. PMID 17015866. [e]
  3. ↑ Katz HP, Kaltsounis D, Halloran L, Mondor M (2008). "Patient Safety and Telephone Medicine : Some Lessons from Closed Claim Case Review". J Gen Intern Med. DOI:10.1007/s11606-007-0491-y. PMID 18228110. Research Blogging.
  4. ↑ Localio AR, Lawthers AG, Brennan TA, et al (1991). "Relation between malpractice claims and adverse events due to negligence. Results of the Harvard Medical Practice Study III". N. Engl. J. Med. 325 (4): 245–51. PMID 2057025. [e]
  5. ↑ Studdert DM, Mello MM, Gawande AA, et al (2006). "Claims, errors, and compensation payments in medical malpractice litigation". N. Engl. J. Med. 354 (19): 2024–33. DOI:10.1056/NEJMsa054479. PMID 16687715. Research Blogging.
  6. ↑ Anonymous. Expertise in Law, Medicine, and Health Care. U.S. Agency for Healthcare Research and Quality. Retrieved on 2009-01-15.
  7. ↑ Anonymous. From the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care. U.S. Agency for Healthcare Research and Quality. Retrieved on 2009-01-15.
  8. ↑ Hulka BS et al. (March 2000). "Experience of a scientific panel formed to advise the federal judiciary on silicone breast implants". N Engl J Med 342: 812–5. PMID 10717019. [e]
  9. ↑ 9.0 9.1 Lewis MH, Gohagan JK, Merenstein DJ (June 2007). "The locality rule and the physician's dilemma: local medical practices vs the national standard of care". JAMA 297 (23): 2633–7. DOI:10.1001/jama.297.23.2633. PMID 17579232. Research Blogging.
  10. ↑ Merenstein D (January 2004). "A piece of my mind. Winners and losers". JAMA 291 (1): 15–6. DOI:10.1001/jama.291.1.15. PMID 14709561. Research Blogging.
  11. ↑ Krist AH, Woolf SH, Johnson RE (2007). "How physicians approach prostate cancer screening before and after losing a lawsuit". Ann Fam Med 5 (2): 120–5. PMID 17389535. PMC 1838685. [e]
  12. ↑ Weir SS, Curtis P, McNutt RA (1990). "Expert testimony based on decision analysis: a malpractice case report". J Gen Intern Med 5 (5): 406–9. PMID 2231036. [e]
  13. ↑ 13.0 13.1 McDonnell WM, Guenther E (December 2008). "Narrative review: do state laws make it easier to say "I'm sorry?"". Ann. Intern. Med. 149 (11): 811–6. PMID 19047028. [e]
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