Professional liability in oral surgery : legal and medical study of 63 court sentences

Objectives: Dentistry, like all other health care professions, has in recent years been subjected to an increase in legal pressure by patients. Nevertheless, there are areas of activity in dentistry in which, whether because of their frequency or due to the importance of the damage and sequelae claimed, this legal pressure is greater. Amongst these areas of activity is that of oral surgery. Study design: To be meticulously analyzed in this report are 63 sentences issued by courts of second instance or higher levels regarding lawsuits involving oral surgery. The data collection file includes 13 variables. The descriptive and comparative statistical study by cross-referencing certain variables provides us with a clear and accurate picture of the lawsuit profile. Results and conclusions: Implantological surgery was the practice subject to the most claims due to surgery (55.6 percent: 35 sentences), and it drew our attention that in 71.4% of all cases (45 sentences) there was a ruling against the professional. The most frequent range of damage payments was between ?18,001 and ?60,000 (40.9%: 18 sentences), the highest amount having been ?24,000, an important factor to take into account when contracting professional civil liability insurance. © Medicina Oral S. L

Observatorio Complutense para la Seguridad Clínica Odontológica

Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaFALSEsubmitte

Analysis of 415 adverse events in dental practice in Spain from 2000 to 2010

Introduction: The effort to increase patient safety has become one of the main focal points of all health care profes - sions, despite the fact that, in the field of dentistry, initiatives have come late and been less ambitious. The main objective of patient safety is to avoid preventable adverse events to the greatest extent possible and to limit the negative consequences of those which are unpreventable. Therefore, it is essential to ascertain what adverse events occur in each dental care activity in order to study them in-depth and propose measures for prevention. Objectives: To ascertain the characteristics of the adverse events which originate from dental care, to classify them in accordance with type and origin, to determine their causes and consequences, and to detect the factors which facilitated their occurrence. Material and Methods: This study includes the general data from the series of adverse dental vents of the Spanish Observatory for Dental Patient Safety (OESPO) after the study and analysis of 4,149 legal claims (both in and out of court) based on dental malpractice from the years of 2000 to 2010 in Spain. Results: Implant treatments, endodontics and oral surgery display the highest frequencies of adverse events in this series (25.5%, 20.7% and 20.4% respectively). Likewise, according to the results, up to 44.3% of the adverse events which took place were due to predictable and preventable errors and complications. Conclusions: A very significant percentage were due to foreseeable and preventable errors and complications that should not have occurred

Professional Liability in Oral Surgery e526 Journal section: Oral Surgery Publication Types

Abstract Objectives: Dentistry, like all other health care professions, has in recent years been subjected to an increase in legal pressure by patients. Nevertheless, there are areas of activity in dentistry in which, whether because of their frequency or due to the importance of the damage and sequelae claimed, this legal pressure is greater. Amongst these areas of activity is that of oral surgery. Study design: To be meticulously analyzed in this report are 63 sentences issued by courts of second instance or higher levels regarding lawsuits involving oral surgery. The data collection file includes 13 variables. The descriptive and comparative statistical study by cross-referencing certain variables provides us with a clear and accurate picture of the lawsuit profile. Results and conclusions: Implantological surgery was the practice subject to the most claims due to surgery (55.6 percent: 35 sentences), and it drew our attention that in 71.4% of all cases (45 sentences) there was a ruling against the professional. The most frequent range of damage payments was between €18,001 and €60,000 (40.9%: 18 sentences), the highest amount having been €24,000, an important factor to take into account when contracting professional civil liability insurance

The clinical safety of disabled patients: proposal for a methodology for analysis of health care risks and specific measures for improvement

The clinical risks associated with health care have been a known factor since ancient times, and their prevention has constituted one of the foundations of health care. However, concern for the risks involved in health care treatments has risen very significantly in recent years, becoming a modern current of concern for clinical health care risks which is referred to by the name of "patient safety" in the scientific literature. Unfortunately, there are no studies on patient safety in dental practice or case studies of adverse events in this practice. In addition to the lack of studies on adverse events in regular dental practice, there are even fewer references to treatment for disabled patients. In this article, we provide a "proposal for analysis" of the clinical risks associated with treating disabled patients, which will make it possible to evaluate the health care risks associated with the treatment of patients who have a specific disability, at one determined moment and in one specific environment

Application of the failure mode and effect analysis to improve the security in the mobilization bed-armchair of the intubated critical patient

El objetivo del estudio es analizar, a través de la herramienta AMFE (Análisis Modal de Fallos y Efectos), la movilización cama-sillón del paciente crítico intubado en la Unidad de Cuidados Intensivos. Para ello se realizó una tormenta de ideas dentro del servicio para decidir los posibles errores más frecuentes en el proceso. Posteriormente, se aplicó el método AMFE, con sus fases, priorizando el riesgo conforme al índice NPR (Número de Priorización de Riesgo), seleccionando acciones de mejora en los que tienen un NPR mayor de 300. Como resultado hemos obtenido 88 modos de fallo de los cuales 40 superaban el NPR de 300. Tras nuestro resultado, se han propuesto 69 acciones de mejora en aquellos modos de fallo con puntuaciones NPR superiores a 300. La conclusión del estudio es que AMFE permite anticiparnos a los posibles fallos del proceso para proponer acciones de mejora en aquellos que superan un NPR de 300.The objective of the study is to analyze, through the FMAE (Failure Mode and Effect Analysis) tool, bed-chair mobilization of intubated critical patients in the Intensive Care Unit. In this way, brainstorming was carried out within the service to determine the potential errors which were most frequent in the process. After this, the FMAE method was applied, including its stages, prioritizing the risk according to the RPN index (Risk Prioritization Number), and selecting improvement actions in which they have an RPN of more than 300. As a result, we have obtained 88 failure modes, of which 40 surpassed an RPN of 300. After our result, 69 improvement actions have been proposed in those failure modes with RPN scores above 300. The conclusion of the study is that AMFE allows us to anticipate the possible failures of the process in order to propose actions of improvement in those that exceed an RPN of 300

Judicial consequences in Spain for the completion of the medical death certificate

The completion of the death certificate is indispensable in Spain for a death to be recorded in the civil registry. Occasionally, doctors may be reluctant to sign a death certificate due to possible legal consequences. This study seeks to analyse the possible judicial consequences doctors may face upon filling out this medico-legal document. Sentences published on the Judicial Power's website between 2009 and 2019 containing the term "death certificate" were analysed. From a total of 2100 sentences examined, only 15 were found to contain the term "death certificate" as part of the claim. In only 7 of these cases the claim was made against the physician, and in 5 the physician was found guilty. Three of them concluded falsity via criminal proceedings, one via administrative proceedings for refusing to sign the certificate and one through civil proceedings for filling out an erroneous antecedent cause of death. In view of the above, it can be inferred that the completion of the death certificate poses few judicial consequences for physicians. In addition, this study reveals the importance of the death certificate document as evidence in judicial proceedings