domingo, 18 de septiembre de 2011

Responsabilidad médica y litigios


El daño psicológico ante una demanda y cómo tratarlo
Lic. Psic. Sandra Orta-Nava, Lic. Psic. Elvira Trinidad Velázquez-Pérez, Dra. Diana Eugenia Montero-Velázquez
Egresada de La Salle. Licenciada en Psicología. Especialidad Psicología del Trabajo. Especialidad Psicología Forense. Egresada de la UNAM. Licenciada en Psicología. Especialidad en PAIDEIA. Especialidad en Psicología Forense. Egresada de la UNAM. Médico Cirujano. Especialidad Anestesiología. Médico Forense. Especialidad en Criminalística. Instituto Nacional de Ciencias Penales. Licenciada en Derecho.
Revista Mexicana de Anestesiología  Volumen 34, Suplemento 1, abril-junio 2011 
Al hablar del anestesiólogo, estamos hablando de alguien que se da a la tarea de estudiar básicamente para suprimir el dolor en las grandes operaciones quirúrgicas. Cabe destacar que el médico especialista en anestesio¬logía, en el desarrollo de su actividad profesional cotidiana se enfrenta a largas jornadas laborales en ambientes es¬tresantes, trastornos psicosociales, así como una serie de riesgos a causa de agentes biológicos, físicos, de seguridad y químicos propios de su especialidad como son los gases anestésicos. Además de la gran responsabilidad que con¬lleva el tener la vida de otro individuo en sus manos, que lo obliga a establecer diversas estrategias particulares para cada caso, ya que en muchos casos, de la oportunidad con que las aplique dependerá la evolución del paciente. De tal suerte que todos los factores mencionados producen para el anestesiólogo un alto costo para su salud, su rendimiento y su seguridad personal.

http://www.medigraphic.com/pdfs/rma/cma-2011/cmas111k.pdf
Responsabilidad asociada con anestesia obstétrica: un análisis de las reclamaciones cerradas
Liability associated with obstetric anesthesia: a closed claims analysis.
Davies JM, Posner KL, Lee LA, Cheney FW, Domino KB.
Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195, USA. jodavies@u.washington.edu
Anesthesiology. 2009 Jan;110(1):131-9.
Abstract
BACKGROUND: Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the American Society of Anesthesiologists Closed Claims database. METHODS: Obstetric anesthesia claims for injuries from 1990 to 2003 (1990 or later claims; n = 426) were compared to obstetric claims for injuries before 1990 (n = 190). Chi-square and z tests compared categorical variables; payment amounts were compared using the Kolmogorov-Smirnov test. RESULTS: Compared to pre-1990 obstetric claims, the proportion of maternal death (P = 0.002) and newborn death/brain damage (P = 0.048) decreased, whereas maternal nerve injury (P < 0.001) and maternal back pain (P = 0.012) increased in 1990 or later claims. In 1990 or later claims, payment was made on behalf of the anesthesiologist in only 21% of newborn death/brain damage claims compared to 60% of maternal death/brain damage claims (P < 0.001). These payments in both groups were associated with an anesthesia contribution to the injury (P < 0.001) and substandard anesthesia care (P < 0.001). Anesthesia-related newborn death/brain damage claims had an increased proportion of delays in anesthetic care (P = 0.001) and poor communication (P = 0.007) compared to claims unrelated to anesthesia. CONCLUSION: Newborn death/brain damage has decreased, yet it remains a leading cause of obstetric anesthesia malpractice claims over time. Potentially preventable anesthetic causes of newborn injury included delays in anesthesia care and poor communication between the obstetrician and anesthesiologist

http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2009&issue=01000&article=00024&type=abstract   
 
Litigio de responsabilidad médica en Arabia Saudita
Medical liability litigation in Saudi Arabia.
Al-Saeed AH.
Professor in Anaesthesia & Critical Care Medicine College of Medicine, King Saud University, Chairman of Saudi Anaesthetic Association Member of the Legal Health Organization, Riyadh, Kingdom of Saudi Arabia.
Saudi J Anaesth. 2010 Sep;4(3):122-6.
Abstract
BACKGROUND:
The author analyzed the anesthesia medical malpractice closed claims that were referred to the Legal Health Organization (LHO) in order to evaluate the magnitude and underlying factors of the problem in Saudi Arabia. MATERIALS AND METHODS: Annual reports covering the period from 1420H-1429H (1999-2008) were statistically analyzed to give mean figures and percentages in each annual report, and then demonstrated all together to run the differential analysis together with the trend along the studied period. RESULTS: Data analysis showed an escalating trend for the total number of claims over the study period being started with 440 cases on 1420H and ended with 1356 cases by the year 1429H. The annual percentage of the final verdicts of accusation to the total number of claims presented to all committees ranges between 45.5%-60.2% with a mean value of 49.9%. Distribution of final verdicts among different clinical specialities showed that obstetrics takes the lead with a mean percentage of 25.5% along the studied period (1420H-1429H), followed by the practice of general surgery with a mean percentage of 13.8%. The sector of health care service showed a significant variation in relation to the mean number of final verdicts with accusation along the studied period, being the highest in the Ministry of Health sector with a mean number of 216.8 claims, followed by the private sector with a mean number of 197.3 claims. CONCLUSION: Adherence to the standards of medical practice is by far to the best approach to avoid and reduce the incidence of litigation

http://www.saudija.org/temp/SaudiJAnaesh43122-8163153_224031.pdf  
Atentamente
Anestesiología y Medicina del Dolor

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