Purpose. The use of interventional radiology procedures has considerably increased in recent years, as has the number of related medicolegal litigations. This study aimed to highlight the problems underlying malpractice claims in interventional radiology and to assess the importance of the informed consent process. Materials and methods. The authors examined all insurance claims relating to presumed errors in interventional radiology filed by radiologists over a period of 14 years after isolating them from the insurance database of all radiologists registered with the Italian Society of Medical Radiology (SIRM) between 1 January1993 and 31 December 2006. Results. In the period considered, 98 malpractice claims were filed against radiologists who had performed interventional radiology procedures. In 21 cases (21.4%), the event had caused the patient’s death. In >80% of cases, the event occurred in a public facility. The risk of a malpractice claim for a radiologist practising interventional procedures is 47 per 1,000, which corresponds to one malpractice claim for each 231 years of activity. Discussion. Interventional radiology, a discipline with a biological risk profile similar to that of surgery, exposes practitioners to a high risk of medicolegal litigation both because of problems intrinsic to the techniques used and because of the need to operate on severely ill patients with compromised clinical status.Conclusions. Litigation prevention largely depends on both reducing the rate of medical error and providing the patient with correct and coherent information. Adopting good radiological practices, scrupulous review of procedures and efficiency of the instruments used and audit of organisational and management processes are all factors that can help reduce the likelihood of error. Improving communication techniques while safeguarding the patient’s right to autonomy also implies adopting clear and rigorous processes for obtaining the patient’s informed consent to the medical procedure.
Obiettivo. Il ricorso alle procedure di radiologia interventistica è sensibilmente aumentato negli ultimi anni; di pari passo si è notato un incremento del contenzioso medico-legale ad esse associato. Questo studio mira a sottolineare i problemi all’origine delle denunce per malapratica in radiologia interventistica, ed a valutare l’importanza del consenso informato. Materiali e metodi. Sono state esaminate tutte le denunce assicurative causate da presunti errori in radiologia interventistica in un periodo di 14 anni, enuncleandole dal data-base assicurativo dei radiologi iscritti alla Società Italiana di Radiologia Medica (SIRM) dal 01/01/1993 al 31/12/2006. Risultati. Nel periodo in esame sono state sporte 98 denunce contro radiologi che avevano effettuato procedure interventistiche. In 21 casi (21,4%) l’evento aveva causato la morte del paziente. In oltre l’80% dei casi l’evento lesivo era occorso in una struttura pubblica. Il rischio di ricevere una denuncia per presunta malapratica per un radiologo che pratichi tecniche interventistiche è pari al 47 per mille, il che corrisponde ad una denuncia per ogni 21 anni di attività. Discussione. La radiologia interventistica, attività sovrapponibile per profilo di rischio biologico alle procedure chirurgiche, espone gli operatori ad un elevato rischio di contenzioso medico-legale sia per problemi intrinseci alle tecniche usate, sia per la necessità dioperare su soggetti con gravi patologie, e in condizioni cliniche compromesse. Conclusioni. La prevenzione del contenzioso dipende in gran parte da una riduzione della percentuale di errore medico abbinata ad una corretta ed organica informazione del paziente. L’adozione di buone pratiche radiologiche, la scrupolosa revisione delle procedure e dell’efficienza tecnica degli strumenti usati, la verifica delle procedure organizzative e gestionali sono i fattori che riducono la probabilità dell’errore. Il miglioramento delle tecniche di comunicazione, nel rispetto dell’autonomia del paziente, passa anche attraverso l’adozione di procedure chiare e rigorose per l’ottenimento del consenso all’atto medico.
Magnavita, N., Fileni, A., Mirk, P., Magnavita, G., Ricci, S., Cotroneo, A. R., Malpractice claims in interventional radiology: frequency, characteristics and protective measures., <<LA RADIOLOGIA MEDICA>>, 2013; 118 (Marzo): 504-517. [doi:10.1007/s11547-012-0878-7] [http://hdl.handle.net/10807/51019]
Malpractice claims in interventional radiology: frequency, characteristics and protective measures.
Magnavita, Nicola;
2013
Abstract
Purpose. The use of interventional radiology procedures has considerably increased in recent years, as has the number of related medicolegal litigations. This study aimed to highlight the problems underlying malpractice claims in interventional radiology and to assess the importance of the informed consent process. Materials and methods. The authors examined all insurance claims relating to presumed errors in interventional radiology filed by radiologists over a period of 14 years after isolating them from the insurance database of all radiologists registered with the Italian Society of Medical Radiology (SIRM) between 1 January1993 and 31 December 2006. Results. In the period considered, 98 malpractice claims were filed against radiologists who had performed interventional radiology procedures. In 21 cases (21.4%), the event had caused the patient’s death. In >80% of cases, the event occurred in a public facility. The risk of a malpractice claim for a radiologist practising interventional procedures is 47 per 1,000, which corresponds to one malpractice claim for each 231 years of activity. Discussion. Interventional radiology, a discipline with a biological risk profile similar to that of surgery, exposes practitioners to a high risk of medicolegal litigation both because of problems intrinsic to the techniques used and because of the need to operate on severely ill patients with compromised clinical status.Conclusions. Litigation prevention largely depends on both reducing the rate of medical error and providing the patient with correct and coherent information. Adopting good radiological practices, scrupulous review of procedures and efficiency of the instruments used and audit of organisational and management processes are all factors that can help reduce the likelihood of error. Improving communication techniques while safeguarding the patient’s right to autonomy also implies adopting clear and rigorous processes for obtaining the patient’s informed consent to the medical procedure.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.