[The hospital physician in the conflict between ambulatory and inpatient care]

The case presented demonstrates the typical risk a physician with a hospital affiliation--here: an otorhinolaryngologist--faces in performing ambulatory surgery procedures. After tonsillectomy recurrent haemorrhage was seen in a 5-year old patient during the first two postoperative weeks. Though the patient is finally admitted to a hospital, a further night-time bleeding episode fails to get duly recognised and appropriately controlled. This failure results in a central nervous system damage leaving the child severely and multiply disabled. Five medical experts differ in their judgement of the question whether the attending physician failed to observe medical standards and whether the CNS damage was caused by this failure. The court judged the physician's negligence to be a crude medical error thus leading to a shift in the burden of proof. A legal action for damage against the physician could be successfully filed.