Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study
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참고문헌
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초록
Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea.Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur. (Korean J Pain 2015; 28: 254-264)
Abstract
Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea.Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur. (Korean J Pain 2015; 28: 254-264)
참고문헌 (26)
- Sitzman BT, "Adverse event protocol for interventional pain medicine: the importance of an organized response", Pain Med, 9, pp.S108~S112 (2008)
- 이인호, "의료사고의 책임소재에 관한 실증적 연구", 한국의료법학회지, 13(1), pp.63~70 (2005), 한국의료법학회
- 권무일, "의료사고의 발생유형과 대책 - 마취.통증관리 및 수술관련 의료사고들을 중심으로 -", Korean Journal of Anesthesiology, 53(5), pp.555~564 (2007), 대한마취통증의학회
- Choe H, "Pain clinic 10 years at Chonbuk National University", J Korean Pain Soc, 8, pp.110~116 (1995)
- 박은정, "신경통증클리닉 환자의 1년간 통계고찰", The Korean Journal of Pain, 20(2), pp.17~17 (2007), 대한통증학회
- 신동아, "요추간판탈출증의 수술 전 보존적 치료 기간과 각종 수술 방법의 과학적 근거에 대한 분석", 대한척추신경외과학회지, 6(3), pp.111~123 (2009), 대한척추신경외과학회
- Kim JH, "Current situation and related issues on medical malpractice : an approach form medical sociological perspective", Korean J Sociol, 32, pp.395~426 (1998)
- Fitzgibbon DR, "Chronic pain management: American society of anesthesiologists Closed Claims Project", Anesthesiology, 100, pp.98~105 (2004)
- Domino KB, "Clinical lessons in chronic pain management from the Closed Claims Project", ASA Newsl, 68, pp.25~27 (2004)
- Fitzgibbon DR, "Malpractice claims associated with medication management for chronic pain", Anesthesiology, 112, pp.948~956 (2010)
- Botwin KP, "Ultrasound-guided trigger point injections in the cervicothoracic musculature : a new and unreported technique", Pain Physician, 11, pp.885~889 (2008)
- Narouze S, "Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain", Reg Anesth Pain Med, 40, pp.182~212 (2015)
- Smith SC Jr, "AHA", ACCF Secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease : 2011 update : a guideline from the American Heart Association and American College of Cardiology Foundation, 2011, pp.124, 2458~2473
- Lehmann LJ, "Subdural injection of a local anesthetic with steroids : complication of epidural anesthesia", South Med J, 88, pp.467~469 (1995)
- Lirk P, "Cervical and high thoracic ligamentum flavum frequently fails to fuse in the midline", Anesthesiology, 99, pp.1387~1390 (2003)
- Reina MA, "An in vitro study of dural lesions produced by 25-gauge Quincke and Whitacre needles evaluated by scanning electron microscopy", Reg Anesth Pain Med, 25, pp.393~402 (2000)
- 김연동, "Delayed Pneumocephalus Following Fluoroscopy Guided Cervical Interlaminar Epidural Steroid Injection : A Rare Complication and Anatomical Considerations", 대한신경외과학회지, 57(5), pp.376~378 (2015), 대한신경외과학회
- Friedman DI, "Headache diagnoses in patients with treated idiopathic intracranial hypertension", Neurology, 58, pp.1551~1553 (2002)
- Morain WD, "Wound healing in diabetes mellitus", Clin Plast Surg, 17, pp.493~501 (1990)
- Hae Kwang Lee, "Anaphylactic Shock Caused by the Epidurally-Administered Hyalurinidase", The Korean Journal of Pain, 24(4), pp.221~225 (2011), 대한통증학회
- Lee KS, "We need the board of independent medical examiners in Korea", Korean J Med Law, 9, pp.109~118 (2001)
- "Residency training program: notification 2013-39" (2013)[URL]
- 이강훈, "성상신경절차단 후 생긴 심한 후인두 혈종 -증례보고-", The Korean Journal of Pain, 21(1), pp.62~66 (2008), 대한통증학회
- Yeon Dong Kim, "Pneumocephalus in a Patient with No Cerebrospinal Fluid Leakage after Lumbar Epidural Block - A Case Report -", The Korean Journal of Pain, 25(4), pp.262~266 (2012), 대한통증학회
- Tae Sam Kim, "Air Bubbles Mimic Disc Herniation in MRI after Cervical Epidural Block", The Korean Journal of Pain, 23(3), pp.202~206 (2010), 대한통증학회
- Swerdlow M, "Medico-legal aspects of complications following pain relieving blocks", Pain, 13, pp.321~331 (1982)