Radwan Kassir1, Patrice Lointier2, Chrysoula Papastathi-Boureau3, Jean-Marie Fiquet4, Pierre Blanc5. 1. Department of Bariatric Surgery, CHU Felix-Guyon, Saint-Denis, La Réunion, France. radwankassir42@hotmail.Fr. 2. Department of Digestive Surgery, Clinique de la Châtaigneraie, 63110, Beaumont, France. 3. Department of Endocrinology, Diabetes, Metabolism and Eating Disorders,, Neuchâtel, Switzerland. 4. Department of General Surgery, Bordeaux, France. 5. Department of Bariatric Surgery, Clinique Mutualiste, Saint-Étienne, France.
Abstract
BACKGROUND: Medicolegal expertise concerning bariatric surgery has greatly evolved, both quantitatively and qualitatively, but unfortunately, the jurisprudence is poor on the subject. OBJECTIVES: The aim of this article is to propose a global and practical approach to medical liability in bariatric surgery. SETTING: University Hospital, France METHODS: This is a retrospective study which deals with an analysis of cases of surgical malpractice litigation between 2009 and 2011. Only the malpractice claims taken to the High Court and the Regional Commission of Reconciliation and Compensation have been taken into account in this study. RESULTS: During this period, there were 426 cases of visceral and digestive surgical malpractice litigation, 81 of which involved bariatric surgery (19%). Fistula was the most common complication leading to a malpractice claim (43.67%). The period of time between the allegations and the procedure was 2 years on average, with a range of 1 to 6 years. There were seven fistulas reported with gastric bypass GB (18.5%) and 31 with sleeve gastrectomy SG (81.5%) leading to malpractice claims. In the majority of cases, only the surgeon was implicated. Sometimes the anaesthetist or the surgical staff were implicated separately or "in solidum" with the surgeon. Every surgical technique was examined. CONCLUSION: Patients do not spontaneously differentiate between recovery from a complication and the result of an alleged error. Attention must be paid to the implications and discourteous remarks. Surgical complications are often unpredictable events and are not synonymous with medical mistakes.
BACKGROUND: Medicolegal expertise concerning bariatric surgery has greatly evolved, both quantitatively and qualitatively, but unfortunately, the jurisprudence is poor on the subject. OBJECTIVES: The aim of this article is to propose a global and practical approach to medical liability in bariatric surgery. SETTING: University Hospital, France METHODS: This is a retrospective study which deals with an analysis of cases of surgical malpractice litigation between 2009 and 2011. Only the malpractice claims taken to the High Court and the Regional Commission of Reconciliation and Compensation have been taken into account in this study. RESULTS: During this period, there were 426 cases of visceral and digestive surgical malpractice litigation, 81 of which involved bariatric surgery (19%). Fistula was the most common complication leading to a malpractice claim (43.67%). The period of time between the allegations and the procedure was 2 years on average, with a range of 1 to 6 years. There were seven fistulas reported with gastric bypass GB (18.5%) and 31 with sleeve gastrectomy SG (81.5%) leading to malpractice claims. In the majority of cases, only the surgeon was implicated. Sometimes the anaesthetist or the surgical staff were implicated separately or "in solidum" with the surgeon. Every surgical technique was examined. CONCLUSION:Patients do not spontaneously differentiate between recovery from a complication and the result of an alleged error. Attention must be paid to the implications and discourteous remarks. Surgical complications are often unpredictable events and are not synonymous with medical mistakes.
Entities:
Keywords:
Bariatric surgical procedures; Branchet medical professional liability insurance; Malpractice claims; Medicolegal analysis
Authors: Jerome H Liu; David Zingmond; David A Etzioni; Jessica B O'Connell; Melinda A Maggard; Edward H Livingston; Carson D Liu; Clifford Y Ko Journal: Am Surg Date: 2003-10 Impact factor: 0.688