Ölümle Sonuçlanmış Üroloji Vakalarında Tıbbi Uygulama Hatalarının Değerlendirilmesi

Yıl 2022, , 431 - 436, 30.05.2022

Erdem Hösükler , İbrahim Üzün , Buğra Kaan Yazgı , Bilgin Hösükler

https://doi.org/10.16899/jcm.1034411

Öz

Amaç: Çalışmamızda Üroloji uzman hekimleri hakkında 2010-2015 yılları arasında ölümle sonuçlanan tıbbi kötü uygulama iddiası içeren ve Adli Tıp Kurumu (ATK) 1. İhtisas Kurulunca değerlendirilen 96 olgunun sunulması ve tıbbi kötü uygulama iddiaları ile ilgili üroloji hekimlerinin farkındalığının arttırılması amaçlanmıştır.
Gereç-Yöntem: Adli Tıp Kurumu 1. İhtisas Kurulunca 2010-2015 yılları arasında düzenlenen raporlar retrospektif olarak incelenmiş ve Üroloji kliniklerinde tedavi gören, tıbbi uygulama hatası iddiası bulunan ve ölümle sonuçlanan olguların tamamı çalışmaya dahil edilmiştir.
Bulgular: Çalışmaya 96 olgu dahil edilmiştir. Olguların 16’sında (%16,7) tıbbi kötü uygulama olduğu, 80’inde (%83,3) olmadığı yönünde rapor düzenlenmiştir. Olguların 76’sının (%79,2) kadın, en sık yaş aralığının 60 yaş ve üzeri (n:46 %47,9); ortalama yaşın 54,90±19,59 olduğu tespit edilmiştir. Yetmiş üç (%76) olgu elektif şartlarda takip edilmiştir. Olguların 20’sinde (%20,8) bir komplikasyon gelişmiştir. Olguların 68’inde (%70,8) cerrahi tedavi uygulanmıştır. Yirmi (%20,8) olgu üriner sistem taş hastalığı ve 16 (%16,7) olgu benign prostat hiperplazisi tanısı almıştır. Kurul tarafından en sık tedavi eksikliği (n:6, %37,5) nedeniyle doktora kusur atfedilmiştir.
Sonuç: Tıbbi uygulama hatası iddiası bulunan olguların kapsamlı incelemesinin bu olguların daha iyi anlaşılmasına, sunulan tıbbi hizmetin ve toplum sağlığının iyileşmesine katkıda bulunacağını düşünmekteyiz.

Anahtar Kelimeler

Tıbbi uygulama hatası, Üroloji, Adli tıp

Destekleyen Kurum

Yok

Proje Numarası

Yok

Evaluation of Medical Malpractice in Urology Cases Resulting in Death

Öz

Aim: This study aimed to present 96 cases evaluated by the 1st Specialization Committee of The Council of Forensic Medicine, which included medical malpractice claims about urologists resulting in death between 2010 and 2015 and to increase the awareness of urologists about medical malpractice claims.
Materials and methods: The reports prepared by the 1st Specialization Committee of The Council of Forensic Medicine between 2010–2015 were reviewed retrospectively. All of the cases treated in Urology clinics, alleged medical malpractice, and resulted in death, participated in the study.
Results: In this study, 96 cases were included. It was reported that there was medical malpractice in 16 (16.7%) cases. Seventy–six of the patients (79.2%) were female; the most common age range was ≥ 60 years (n:46 47.9%); the mean age was 54,90±19,59 years. Seventy–three (76%) cases were followed up under elective conditions. Complications developed in 20 (20.8%) of the cases during their treatment course. Surgical treatment was applied in 68 (70.8%) patients. Twenty (20.8%) cases were diagnosed with urinary system stone disease and 16 (16.7%) cases with benign prostatic hyperplasia. The committee attributed malpractice to the doctors most frequently due to lack of treatment (n:6, 37.5%).
Conclusion: We think that a comprehensive review of the cases with medical malpractice claims will contribute to a better understanding of these cases, the improvement of the medical service provided, and public health.

Anahtar Kelimeler

Medical malprtactice, Urology, Forensic medicine

Proje Numarası

Yok

Kaynakça

• Kasap H, Akar T, Demirel B, et al. The Change of Preference Prioritıies on Examinatıon for Specialty in Medicine by Years of High Risky Medical Branches in Medical Malpractice. Bull Leg Med 2015;20(1):34-37.
• Duty B, Okhunov Z, Okeke Z, Smith A. Medical malpractice in endourology: analysis of closed cases from the State of New York. J Urol. 2012;187(2):528-32.
• Benson JS, Coogan CL. Urological malpractice: analysis of indemnity and claim data from 1985 to 2007. J Urol. 2010;184(3):1086-90. Sherer BA, Coogan CL. The Current State of Medical Malpractice in Urology. Urology. 2015;86(1):2-9.
• Sobel DL, Loughlin KR, Coogan CL. Medical malpractice liability in clinical urology: a survey of practicing urologists. J Urol. 2006;175(5):1847-51.
• Studdert DM, Mello MM, Sage WM, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA. 2005;293(21):2609-17.
• Li H, Wu X, Sun T, et al. Claims, liabilities, injures and compensation payments of medical malpractice litigation cases in China from 1998 to 2011. BMC Health Serv Res. 2014;14:390.
• Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629-36.
• Arimany-Manso J, Gómez-Durán EL, Aubia-Marimon J. Malpractice claims by specialty in a non-US setting. Gac Sanit. 2013;27(1):92-3.
• Tümer AR, Dener C. Evaluation of surgical malpractice in Turkey. Leg Med 2006; 8:11–15.
• Ekmekci PE, Kurtoglu B, Güner MD. Change in choices regarding the residency of Turkish medical students during medical education. Tıp Egitimi Dunyasi. 2021;20(60):35-48.
• Johnston WF, Rodriguez RM, Suarez D, Fortman J. Study of medical students’ malpractice fear and defensive medicine: a “hidden curriculum?”. West J Emerg Med. 2014;15(3):293-8.
• Bole R, Linder BJ, Gopalakrishna A, et al. Malpractice Litigation in Iatrogenic Ureteral Injury: a Legal Database Review. Urology. 2020;146:19-24.
• Badger WJ, Moran ME, Abraham C, Yarlagadda B, Perrotti M. Missed diagnoses by urologists resulting in malpractice payment. J Urol. 2007;178(6):2537-9.
• Kaplan GW. Malpractice risks for urologists. Urology 1998;51(2):183-5.
• Kahan SE, Goldman HB, Marengo S, Resnick MI. Urological medical malpractice. 2001; 165(5):1638-42.
• Sunaryo PL, Colaco M, Terlecki R. Penile prostheses and the litigious patient: a legal database review. J Sex Med. 2014;11(10):2589-94.
• Gaither TW, Copp HL. State appellant cases for testicular torsion: Case review from 1985 to 2015. J Pediatr Urol. 2016;12(5):291.e1-291.e5.
• Awad MA, Osterberg EC, Chang H, et al. Urethral catheters and medical malpractice: a legal database review from 1965 to 2015. Transl Androl Urol. 2016;5(5):762-73.
• Çom U, Üzüm İ, Gümüş B. Evaluation of Obstetrics and Gynecology Medical Malpractice Claims Resulting to Death.J Contemp Med 2020;10(4):567-72.
• Üzün İ, Özdemir E, Esen Melez İ, Melez DO, Akçakaya A. Evaluation of medical malpractice in emergency and elective general surgery cases resulting in death. Ulus Travma Acil Cerrahi Derg. 2016;22(4):365-73.
• Demirel B. Legal Responsibilities of a Physician. Gazi Med J 2005;16(3):99–106.
• Bengidal MS, Keskinkılıç B, Kuvan L, Odabaşı O, Bengidal S. Legal Liability of Physicians in Emergency Services.Sted 2001;10(8):301–305.
• Somville FJ, van Sprundel M, Somville J. Analysis of surgical errors in malpractice claims in Belgium. Acta Chir Belg. 2010;110(1):11-8.
• Perrotti M, Badger W, Prader S, Moran ME. Medical malpractice in urology, 1985 to 2004: 469 consecutive cases closed with indemnity payment. J Urol. 2006;176(5):2154-7.
• Osman NI, Collins GN. Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims. BJU Int. 2011;108(2):162-5.
• Stimson CJ, Pichert JW, Moore IN, et al. Medical malpractice claims risk in urology: an empirical analysis of patient complaint data. J Urol. 2010;183(5):1971-6.