BACKGROUND: Knowledge about medicolegal claims is important for risk management and clinical practice. This study presents the first comprehensive collated data for vascular surgical practice. METHOD: Details of claims notified to the National Health Service Litigation Authority (NHSLA) since its inception in 1995, and to the Medical Defence Union (MDU) from 1990-1999 were analysed. RESULTS: A total of 424 claims were notified--170 NHSLA and 254 MDU (176 from surgeons who described themselves as 'vascular' and 248 from 'general surgeons'). Varicose veins were the commonest condition involved (244 claims) and nerve damage was the most frequent complaint (76), followed by incorrect or unsatisfactory surgery (35), and damage to the femoral vein (16) or artery (13). Arterial claims (174) against vascular surgeons comprised 88% in the NHS but only 39% in private practice: 45 related to aortic grafting, 28 to other bypass grafts, and 36 alleged failure to recognise or treat ischaemia. CONCLUSIONS: The likely cause of many of these claims was failure to advise patients about potential risks and expected benefits. Recognition of the areas of highest risk, with improvements in communication and record keeping, may limit future claims. (+info)
Recommendations of the National Heart, Lung, and Blood Institute Heart and Lung Xenotransplantation Working Group.
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The National Heart, Lung, and Blood Institute (NHLBI) recently convened the Heart and Lung Xenotransplantation Working Group to identify hurdles to the clinical application of xenotransplantation, defined as the use of animal organs or tissue for transplantation, and to recommend possible solutions to these problems. The group consisted of experts in xenotransplantation from academia, industry, and federal agencies, and the discussions focused on those areas within the mission of the NHLBI. The areas covered included immunologic and physiological barriers to xenotransplantation, the limitations of the current animal models, the need for collaboration among groups, the high costs of studies using nonhuman primates and genetic engineering of pigs, and the unique problems of lung xenotransplantation. This report is a summary of those discussions. (+info)
The shredding of BAT's defence: McCabe v British American Tobacco Australia.
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On 11 April 2002, a Victorian supreme court jury ordered British American Tobacco Australia to pay Rolah McCabe $A700 000 in damages. Rolah McCabe is a 51 year old woman dying of lung cancer. She is the first smoker ever in Australia to obtain a damages verdict against the tobacco industry (+info)
The Ionising Radiation (Medical Exposure) regulations (IRME) 2000--radiological considerations.
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1) IRME regulations apply to the trust and not to the individual clinician. 2) Each trust must have written regulations outlining how the IRME regulations are to be applied locally. 3) The IRME regulations and, almost certainly, the local directions, have the force of the law and breaches may be dealt with by both the criminal and the civil courts. 4) All radiological examinations using ionising radiation must be reported either by a radiologist or a clinician, and the report must be filed in the patient's case notes. 5) It is unlawful to request a radiological examination if it is not to be reported. 6) No regulation mentions the quality or timeliness of the radiological report. (+info)
Reductions in injury crashes associated with red light camera enforcement in oxnard, california.
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OBJECTIVES: This study estimated the impact of red light camera enforcement on motor vehicle crashes in one of the first US communities to employ such cameras-Oxnard, California. METHODS: Crash data were analyzed for Oxnard and for 3 comparison cities. Changes in crash frequencies were compared for Oxnard and control cities and for signalized and nonsignalized intersections by means of a generalized linear regression model. RESULTS: Overall, crashes at signalized intersections throughout Oxnard were reduced by 7% and injury crashes were reduced by 29%. Right-angle crashes, those most associated with red light violations, were reduced by 32%; right-angle crashes involving injuries were reduced by 68%. CONCLUSIONS: Because red light cameras can be a permanent component of the transportation infrastructure, crash reductions attributed to camera enforcement should be sustainable. (+info)
Warning: can lawyers seriously damage your health service?
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This paper looks at a personal experience of threatened legal action when a patient read that IUD usage was contraindicated in cases of cervical pre-cancer. Important medico-legal issues are raised, and the author asks how much time is spent watching our backs rather than caring for patients? (+info)
Effects of the civil procedure rules on clinical negligence claims.
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The frequency with which clinicians can expect to face allegations of clinical negligence and court proceedings related to those allegations is likely to increase in coming years. The processes of investigation and defence have been modified by the introduction of the Civil Procedure Rules in 1999. This review outlines these developments and emphasises the need for speedy and comprehensive responses by doctors involved in such procedures. (+info)
The rise of nursing home litigation: findings from a national survey of attorneys.
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Lawsuits against nursing homes are a relatively recent phenomenon. Despite a growing sense of alarm among policymakers, little is known about these lawsuits' scale, dynamics, or outcomes. To describe these characteristics, we conducted a Web-based survey of attorneys nationwide who bring and defend this litigation. Our respondents and their firms were involved in 4,677 and 8,256 claims, respectively, in 2001; more than half of these claims were in Florida and Texas. The costs of nursing home litigation are substantial, both in the aggregate and per claim, especially in states where the litigation is most prevalent. These findings elevate concerns about quality of nursing home care and indicate that litigation diverts resources from resident care, which may fuel quality problems. (+info)