Literature DB >> 16632999

Transparent and open discussion of errors does not increase malpractice risk in trauma patients.

Ronald M Stewart1, Michael G Corneille, Joe Johnston, Kathy Geoghegan, John G Myers, Daniel L Dent, Marilyn McFarland, Joshua Alley, Basil A Pruitt, Stephen M Cohn.   

Abstract

OBJECTIVE: We set out to determine if there is an increased medical malpractice lawsuit rate when trauma patient cases are presented at an open, multidisciplinary morbidity and mortality conference (M&M).
INTRODUCTION: Patient safety proponents emphasize the importance of transparency with respect to medical errors. In contrast, the tort system focuses on blame and punishment, which encourages secrecy. Our question: Can the goals of the patient safety movement be met without placing care providers and healthcare institutions at unacceptably high malpractice risk?
METHODS: The trauma registry, a risk management database, along with the written minutes of the trauma morbidity and mortality conference (M&M) were used to determine the number and incidence of malpractice suits filed following full discussion at an open M&M conference at an academic level I trauma center.
RESULTS: A total of 20,749 trauma patients were admitted. A total of 412 patients were discussed at M&amp;M conference and a total of seven lawsuits were filed. Six of the patients were not discussed at M&amp;M prior to the lawsuit being filed. One patient was discussed at M&amp;M prior to the lawsuit being filed. The incidence of lawsuit was calculated in three groups: all trauma patients, all trauma patients with complications, and all patients presented at trauma M&amp;M conference. The ratio of lawsuits filed to patients admitted and incidence in the three groups is as follows: All Patients, 7 lawsuits/20,479 patients (4.25 lawsuits/100,000 patients/year); M&amp;M Presentation, 1 lawsuit/421 patients (29.6 lawsuits/100,000 patients/year); All Trauma Complications, 7 lawsuits/6,225 patients (14 lawsuits/100,000 patients/year). Patients with a complication were more likely to sue (P < 0.01); otherwise, there were no statistical differences between groups.
CONCLUSIONS: A transparent discussion of errors, complications, and deaths does not appear to lead to an increased risk of lawsuit.

Entities:  

Mesh:

Year:  2006        PMID: 16632999      PMCID: PMC1570545          DOI: 10.1097/01.sla.0000217304.65877.27

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  14 in total

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3.  Reporting of medical errors: time for a reality check.

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4.  Reporting of adverse events.

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Journal:  N Engl J Med       Date:  2002-11-14       Impact factor: 91.245

5.  The new medical malpractice crisis.

Authors:  Michelle M Mello; David M Studdert; Troyen A Brennan
Journal:  N Engl J Med       Date:  2003-06-05       Impact factor: 91.245

6.  Medical malpractice.

Authors:  David M Studdert; Michelle M Mello; Troyen A Brennan
Journal:  N Engl J Med       Date:  2004-01-15       Impact factor: 91.245

7.  Robert E. Gross Lecture. Making health care safe: are we up to it?

Authors:  Lucian L Leape
Journal:  J Pediatr Surg       Date:  2004-03       Impact factor: 2.545

8.  Quality, safety, and transparency.

Authors:  Hiram C Polk
Journal:  Ann Surg       Date:  2005-09       Impact factor: 12.969

9.  Relation between negligent adverse events and the outcomes of medical-malpractice litigation.

Authors:  T A Brennan; C M Sox; H R Burstin
Journal:  N Engl J Med       Date:  1996-12-26       Impact factor: 91.245

10.  Complications in surgical patients.

Authors:  Mark A Healey; Steven R Shackford; Turner M Osler; Frederick B Rogers; Elizabeth Burns
Journal:  Arch Surg       Date:  2002-05
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2.  Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face.

Authors:  Kjetil Søreide; Andreas J Krüger; Anne Line Vårdal; Christian Lycke Ellingsen; Eldar Søreide; Hans Morten Lossius
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3.  Fatal surgical or procedure-related complications: a Finnish registry-based study.

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