Malpractice in paediatric minimally invasive surgery - a current concept: Results of an international survey
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Published on: January 17, 2011
Ciro Esposito1, Maria Escolino1, Marcela Bailez2
11 Department of Translational Medical Sciences, Federico II University of Naples, Italy.
Insights
Malpractice claims in pediatric minimally invasive surgery (MIS) are rare, with surgeons absolved in all cases. Expert legal counsel and continuous training are vital for supporting surgeons facing investigations.
Area of Science:
- Pediatric Surgery
- Medical Malpractice Law
- Surgical Ethics
Background:
- Malpractice litigation poses risks to surgeons, impacting their professional lives.
- Understanding the landscape of malpractice in pediatric minimally invasive surgery (MIS) is crucial.
Purpose of the Study:
- To evaluate malpractice claims in pediatric MIS.
- To explore surgeons' attitudes towards these claims.
- To identify prevention strategies and support mechanisms for investigated surgeons.
Main Methods:
- An observational, multicenter, questionnaire-based study.
- Survey distributed via mail to 24 pediatric surgeons across 13 countries.
- Data collected on malpractice claims, reasons, outcomes, and expert witness roles.
Main Results:
- 12.5% of surgeons reported 5 malpractice claims related to MIS.
- Claims stemmed from postoperative complications (60%), delayed diagnosis (20%), and patient death (20%).
- All claims resulted in surgeon absolution, but 40% involved compensation; 45.8% served as expert counsels.
Conclusions:
- Medico-legal issues have minimal direct impact on pediatric MIS practice.
- While surgeons are typically absolved, claims negatively affect reputation and finances.
- Engaging expert pediatric MIS legal counsel, staying updated on innovations, and maintaining liability insurance are key protective measures.
Abstract:
This study aimed to assess malpractice in paediatric minimally invasive surgery (MIS), and attitudes, prevention strategies and mechanisms to support surgeons while they are under investigation. An observational, multicentric, questionnaire-based study was conducted. The survey questionnaire was sent via mail, and it comprised four sections. Twenty-four paediatric surgeons (average age 54.6 years), from 13 different countries, participated in this study. The majority had >15 years of experience in MIS. Three (12.5%) surgeons reported a total of five malpractice claims regarding their MIS activity. The reasons for the claims were a postoperative complication in 3/5 (60%) cases, a delayed/failed diagnosis in 1/5 (20%) cases and the death of the patient in 1/5 (20%) cases. The claims concluded with the absolution of the surgeon in all cases, and monetary compensation to the claimant in two (40%) cases. Eleven (45.8%) surgeons were invited as expert counsels in medico-legal actions. Medico-legal aspects have a minimal impact on the MIS activity of paediatric surgeons. In this series, claims concluded with the absolution of the surgeon in all cases, but they had a negative effect on the surgeon's reputation and finances. A key element in supporting surgeons while they are under investigation is always to choose a surgeon who is an expert in paediatric MIS as legal counsel. A constant update on innovations in paediatric MIS and appropriate professional liability insurance may also play a key role in reducing medico-legal consequences.
