Metodología para la valoración del daño bucodental

Tesis Univ. Complutense de MadridEn la presente tesis doctoral se propone una metodología concisa y reglada para la valoración del daño bucodental y la forma de reflejarla en un informe pericial. También se desarrollan dos baremos. El primero, extenso y detallado, se indica para casos en los que el daño es exclusiva, o casi exclusivamente, dentario, como los derivados de un inadecuado ejercicio de la odontoestomatología. En este baremo, además de las funciones clásicas de los dientes: masticatoria, fonatoria y estética, se proponen dos funciones nuevas: la función prostodoncica y como patrimonio biológico. El otro baremo recogido es un resumen ponderado del primero y se recomienda para daños dentales derivados de accidentes de trafico. En la tesis también se estudian todos los casos odontoestomatológicos llegados a la clínica médico-forense de Madrid desde julio de 1987 a julio de 1993.Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaTRUEpu

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

The assurance of professional liability in practice of the podiatry

El seguro de responsabilidad civil profesional es un requisito obligatorio para la práctica de la podología en el sector privado, también es muy recomendable tenerlo aunque únicamente se trabaje en la asistencia sanitaria pública. Es un producto asegurador que cubre los daños producidos a pacientes debidos al ejercicio profesional, y también la defensa jurídica en esa circunstancia. No todos los seguros de responsabilidad civil profesional que hay en el mercado son similares, hay diferencias importantes que pueden condicionar su adecuación a nuestra actividad. Existen una serie de datos que necesariamente tenemos que conocer sobre nuestro seguro de responsabilidad si es colectivo o individual (el hecho de que se contrate a través de un Colegio Profesional no implica necesariamente que sea colectivo), si tenemos más de un seguro cubriendo la misma actividad, si nuestra sociedad en caso de tenerla está asegurada, si nuestro seguro cubre todas nuestras actividades profesionales, si la cobertura económica es suficiente y si existen franquicias, qué ocurrirá cuando dejemos de trabajar como podólogos, y, por último, asegurarnos de que no existan periodos sin cobertura. Debemos también conocer las exclusiones del seguro, esto es, aquellas circunstancias en las que determinadas actividades no son cubiertas. Por último, tenemos que saber qué hacer respecto al seguro en caso de reclamación legal o riesgo inminente de que ocurra.The assurance of civil professional responsibility is an obligatory requirement for the practice of the chiropody in the private sector, though it is very advisable to have it though only one is employed at the sanitary public assistance. It is an insurance product that covers the damages produced to patients due to the professional exercise, and also the juridical defense in this circumstance. Not all the assurances of civil professional responsibility that exists on the market are similar, there are important differences that can determine its adequacy to the activity. There exist a series of information that necessarily we have to know on our assurance of civil professional if it is collective or individual (the fact that it is contracted across a Professional College it does not imply necessarily that is collective), if we have more than one assurance covering the same activity, if our society in case of having it is assured, if our assurance covers all our professional activities, if the economic coverage is sufficient and if franchises exist, what will happen when we stop working as chiropodists, and, finally, making sure that should not exist periods without coverage. We have to know also the exclusions of the assurance, this is, those circumstances in which certain activities are not covered. Finally, we have to know what to do with regard to the assurance in case of legal claim or imminent risk that it happens

El consentimiento informado en Podología: Legislación, concepto y estructura

Informed Consent has evolved a lot in the recent years despite it was not really accepted at the beginnig by health professionals. From legislative point of view this development has gone through Health General Law (14/1986) where it was already said that it is compulsory to reply the Informed Consent and, on the other hand, the recent Patient Autonomy Law (41/2002) that speaks about what it is use for, who must receive it… and many other concepts. With this law it has been possible to change the relationship between health professionals and patients: It is more important to respect the autonomy of the patient over the paternalistic principle based on “the search for the best for the patient”. At this article, we have reviewed and studied general legislation, as well as its advantages and disadvantages.Es el consentimiento informado uno de los documentos que, a pesar de las reticencias iniciales que creó en los profesionales sanitarios, más ha evolucionado a lo largo de sus ya muchos años de vida. Desde el punto de vista legislativo esta evolución ha pasado por una Ley General de Sanidad que ya hablaba de la obligatoriedad de su cumplimiento a lo más reciente que es la Ley de Autonomía del Paciente, donde especifica su finalidad, a quien va dirigido… y otros muchos conceptos, cambiando la idea de la asistencia al paciente y primando el derecho de autonomía sobre el principio paternalista de “buscar lo mejor para el paciente”. Hemos realizado una revisión del marco legislativo general y recordado la estructura básica del mismo, así como sus ventajas e inconvenientes

Proposal of a "Checklist" for endodontic treatment

Objectives: On the basis of the 'Surgical Checklist' proposed by the WHO, we propose a new Checklist model adapted to the procedures of endodontic treatment. Study Design: The proposed document contains 21 items which are broken down into two groups: those which must be verified before beginning the treatment, and those which must be verified after completing it, but before the patient leaves the dentist's office. Results: The Checklist is an easy-to-use tool that requires little time but provides, order, logic and systematization by taking into account certain basic concepts to increase patient safety. Discussion: We believe that the result is a Checklist that is easy to complete and which ensure the fulfillment of the key points on patient safety in the field of endodontics

Patient safety in dentistry : dental care risk management plan

Objectives: Although the safety of patients has been one of the inherent concerns of dental practice, but because the proposals made in the field of dentistry are few and improperly structured, this paper constitutes an attempt to present a proposal titled "Plan for Dental Health Care Risk Management," promoted by the General Council of Dentists of Spain, including a description of the proposed work methodology. Design: The "risk management plan" proposed in this paper is based on applying the basic concepts dealt with in patient safety to the field of dentistry, due to the fact that the available bibliography contains no specific "health care risk management plan" for dentistry specifically. Results and conclusions: In order to implement health care risk management in the field of dental care provided at any level throughout Spain, a seven-step plan which covers the main objectives in Patient Safety is provided. © Medicina Oral S. L

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

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

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