Liability, Legal

责任,Legal
  • 文章类型: Case Reports
    在医院环境中,对组织不足和/或效率低下的任何责任,或者再次是因为设施的缺陷,或在最高专业人员的工作中可能发现卫生设备不足:医务主任,总经理,和/或其他。该部门内部组织的责任落在复杂结构主任的身上,该部门的缺陷没有及时和充分地报告给最高数字。
    一个61岁的女人,自愿进入精神科。第三天,在清晨,病人是在一楼被发现的,躺在病房入口门附近的地板上,头部受挫伤。该妇女接受了全身CT检查,发现多发性外伤骨折,蛛网膜下腔出血和脾脏完全骨折,手术切除了.三天后,尽管给予了照顾,死亡发生。确定的伤害与二楼楼梯间窗户的自愿降雨一致。警方进行的调查以及内部预防和保护服务负责人和公司风险经理进行的检查,强调了多个关键问题。
    该案例考虑了许多与患者死亡决定论中的责任概况有关的考虑因素,医院的公司未能实施措施,以防止病人的自杀在医院是有影响的。
    UNASSIGNED: In the hospital environment, any liability for organizational inadequacy and/or inefficiency, or again for defects in the facilities, or inadequacy of health equipment may be found in the work of the apex professional figures: Medical Director, the General Manager, and/or others. The responsibility for the internal organization of the department falls on the figure of the Director of the Complex Structure where the deficiencies have not been promptly and adequately reported to the top figures.
    UNASSIGNED: A woman 61-year-old, was admitted on a voluntary basis to the Department of Psychiatry. On the third day, in the early morning hours, the patient was found on the ground floor, lying on the floor near the entrance door of the ward with a lacerated contusion wound to the head. The woman underwent total body CT examination with findings of fractured polytrauma as well as subarachnoid hemorrhage and complete fracture of the spleen, which was surgically removed. Three days later, despite the care given, death occurred. The injuries ascertained were consistent with voluntary precipitation from the second-floor stairwell window. The investigations conducted by the police and the checks carried out by the head of the Internal Prevention and Protection Service and the company\'s Risk Manager, highlighted multiple critical issues.
    UNASSIGNED: The case allows for numerous considerations relating to liability profiles in the determinism of the patient\'s death, the hospital\'s company failure to implement measures to prevent the patient\'s suicide in the hospital was influential.
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  • 文章类型: Journal Article
    克制问题长期以来一直被认为是一个困难的政治和社会局势,影响医疗保健工作人员和设施。在许多公共和私人护理环境中,克制的做法仍然很普遍,但是缺乏能够监测这种现象的系统研究。这个问题的框架基本上涉及个人自由权,由意大利宪法保障。
    开发了一份匿名问卷,其中包含有关限制法规知识的问题,如何,方式,当它们被实施时,和一般信息,如年龄,性别,教育资格,资格,O.Us.属于他们的。使用EpiInfo7.1.5程序(CDC-Atlanta-USA)对收集的数据进行统计学处理(卡方检验)。共完成了1002份问卷。按结构对样本进行分层显示,公共设施占73.9%。指示性数字由23.8%的受访者表示,“医疗记录中没有注明限制”。
    限制对医护人员来说可能是一个真正的风险,侵犯健康责任问题。因此,重要的是提高医疗保健专业人员和高层管理人员对结构需求的认识,在公司层面,符合“身体约束建议”的程序,通过改善符合组织和风险管理标准的护理途径来克服约束的使用。
    UNASSIGNED: The issue of restraint has long been considered a difficult political and social situation, affecting both healthcare wor-kers and facilities. The practice of restraint is still widespread in many public and private care settings, but there is a lack of systemic studies capable of monitoring the phenomenon. The framing of the question essentially concerns the right to personal freedom, guaranteed by the Italian Constitution.
    UNASSIGNED: An anonymous questionnaire was developed containing questions on knowledge of the regulations on restraints, how, ways, and when they are implemented, and general information such as age, gender, educational qualification, qualification, O.Us. to which they belong. The collected data were statistically processed (Chi-square test) with the Epi Info 7.1.5 program (CDC-Atlanta- USA). A total of 1002 questionnaires were completed. The stratification of the sample by structure shows that 73.9% were public facilities. The indicative figure is represented by the 23.8% of respondents who say that \"the restraint is not noted in the medical record\".
    UNASSIGNED: Restraint could be a real risk for the healthcare worker, encroaching on the issue of health liability. It is therefore important to raise awareness among healthcare professionals and top management of the need to structure, at company level, procedures that comply with the \"Recommendations on physical restraint\" to overcome the use of restraint through the improvement of care pathways in compliance with organizational and risk management standards.
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  • 文章类型: Journal Article
    医疗事故诉讼在发达国家相当普遍,导致医疗事故保险的增加。最近的趋势表明,印度正处于医疗事故危机的风口浪尖。针对医生的医疗过失案件有所增加,尽管这些指控往往是轻浮的。在这种情况下,医生可以被认为是医疗过失的第二个受害者。医疗兄弟会的成员在培训期间对法律的了解不多,并且通常对应对此类案件的各种选择以及相关的法律学说幼稚。因此,医生不仅需要保持医学知识和技能的更新,而且还需要获得法律范式的知识。我们的目标是在各种论坛上提高医生对处理过失案件的认识,并通过相关文献分享见解,法院判决和政府命令。我们还绘制了处理投诉的流程,各种法院遵循的程序以及医生可获得的不同程度的补救措施。
    Medical malpractice suits are quite common in developed countries leading to an increase in malpractice insurance. Recent trends indicate that India is at the cusp of a medical malpractice crisis. There has been a rise in medical negligence cases filed against doctors, though often the allegations are frivolous. In such cases, doctors can be considered as the second victim of medical negligence. Members of the medical fraternity do not learn much about law during their training and are often naïve regarding various options available to counter such cases as well as relevant legal doctrines. Doctors thus not only need to remain updated on medical knowledge and skills but also obtain knowledge of legal paradigms. We aim to raise awareness among doctors about handling negligence cases in various forums and share insights through relevant literature, court judgments and government orders. We also map the process of handling complaints, procedures followed in various courts and the different levels of remedies available for doctors.
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  • 文章类型: Classical Article
    自2012年以来,西西里地区政府,鉴于医疗事故索赔的增加,采用了“自我保险系统”,索赔管理活动已委托给索赔管理委员会(CMC),法律第2号也强调了这一点的重要性。24/2017.本研究旨在描述西西里医院CMC的经验,分析索赔的特点,特别是对于有争议的HAIs。医疗保健相关感染(HAIs)仍然是主要的公共卫生问题。住院期间感染的收缩通常导致患者生活质量的显著恶化和住院时间的延长。尽管如此,它也是造成医院和整个卫生系统负担的成本增加的原因。
    该研究调查了在2015年1月至2023年12月期间,一家Messina医院公司收到的索赔的分析,即使是发生在前几年的事件。从数据库中,对公司因HAIs被起诉的案例进行了推断和分析,按年份和部门区分它们。收集的数据用EpiInfo7.1.5程序(CDC-亚特兰大-美国)进行统计学处理。
    CMC的经验强调了投诉的统计显着增加,尤其是与HAI有关的投诉,没有部门的差异。在大多数情况下,CMC承认了医院的责任,并促进了调解的尝试,并采取了风险管理举措。当考虑到2023年3月3日最近的裁决6386/2023时,这一点很重要。
    UNASSIGNED: Since 2012, the Sicilian regional government, in view of the increase in malpractice claims, has adopted a \"self-insurance system\" The claims management activities have been delegated to the Claims Management Committees (CMCs), the importance of which was also emphasized by Law No. 24/2017. This study aims to describe the experience of Sicilian Hospital CMC and analyze the claims\' features, especially for contentious HAIs. Healthcare-associated infections (HAIs) continue to be a major public health concern. The contraction of infection during hospitalization generally results in a significant worsening of the patient\'s quality of life and prolongation of his or her stay. Still, it is also responsible for an increase in costs that burden the hospital and the entire Health System.
    UNASSIGNED: The study investigates the analysis of claims received by a Messina Hospital Company between January 2015 and December 2023 even though for events that occurred in earlier years. From the database, cases in which the Company was sued for HAIs were extrapolated and analyzed, distinguishing them by year and by Department. The data collected were statistically processed with the Epi Info 7.1.5 program (CDC - Atlanta - USA).
    UNASSIGNED: The CMC experience highlighted a statistically significant increase in complaints especially for those relating to HAI, without differences by Department. In most cases, the CMC admitted the hospital\'s liability, and an attempt at conciliation was promoted and moreover risk management initiatives were adopted. This is important when considering the recent ruling 6386/2023 of March 3, 2023.
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  • 文章类型: Case Reports
    机会损失损害赔偿的概念起源于1877年的法国,并于1962年适用于医疗保健。在意大利,它于2004年首次引入医疗保健责任,民事最高法院第4400.意大利法学承认失去机会是独立的,法律和经济上可评估的损害,与实际失去的结果不同。2019年具有里程碑意义的圣马丁判决进一步确定,如果涉及明显的损害,可以要求赔偿。严肃,和一致的价值观。这需要证明行为和失去的机会之间的因果关系,基于既定的民法标准。
    1)一名71岁的男性,其肺癌未被及时诊断,导致生存机会显著减少。2)一名女性,其乳腺癌诊断被推迟,导致更高级的阶段和降低的生存前景。
    在医疗专业责任方面,最高法院要求承认不法行为与损害之间的因果关系具有很高的可能性或确定性。评估包括证明因果联系和失去机会实现的合理概率。假设的损害不足以补偿。
    机会损失的可补偿性依赖于证明过失行为与不确定事件之间的因果关系,对患者非金钱领域的影响是显著的。医药学实践在区分因果关系和损害方面面临挑战,这可能导致生物损害和丧失机会造成的损害之间的混淆。
    UNASSIGNED: The concept of damages for loss of chance originated in France in 1877 and was adapted to healthcare in 1962. In Italy, it was first introduced in healthcare liability in 2004, with Civil Court of Cassation decision No. 4400. Italian jurisprudence recognizes the loss of chance as an independent, legally and economically assessable damage, distinct from the actual outcome lost. The landmark St. Martin Judgments of 2019 further established that such damages can be claimed if they involve appreciable, serious, and consistent values. This requires proving a causal link between the conduct and the lost chance, based on established civil law criteria.
    UNASSIGNED: 1) a 71-year-old man whose lung carcinoma was not diagnosed in time, leading to a significant reduction in survival chances. 2) a woman whose breast cancer diagnosis was delayed, resulting in a more advanced stage and decreased survival prospects.
    UNASSIGNED: In medical professional liability, the Supreme Court requires a high probability or certainty of causation for recognizing the causal link between wrongful conduct and damage. The assessment involves proving both the causal link and the reasonable probability of a lost opportunity\'s realization. Hypothetical damage is insufficient for compensation.
    UNASSIGNED: The compensability of loss of chance relies on proving the causal link between the negligent act and the uncertain event, where the impact on the patient\'s non-pecuniary sphere is significant. Medicolegal practice faces challenges in distinguishing between causality and damage, which can lead to confusion between biological damage and damage from loss of opportunity.
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  • 文章类型: Journal Article
    医疗保健供应发生在各种情况下,与医生和他们的患者可用的资源的变化。COVID-19大流行对现有系统需求的影响导致人们越来越担心资源限制,特别是在农村和偏远地区。本文探讨了医生和医疗保健服务机构在因患者受到伤害而引起的疏忽行为方面的法律责任,部分或全部,由于资源的限制。
    Healthcare provision takes place in a variety of contexts, with variations of resources available to practitioners and their patients. Effects from the COVID-19 pandemic superimposed on existing system demands have driven increasing concern about resource limitations, particularly in rural and remote settings. This article explores the legal liability of medical practitioners and healthcare services with respect to actions in negligence arising from harm to patients suffered, either partly or wholly, as a result of resource limitations.
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  • 文章类型: Case Reports
    气管损伤可能是气管内插管手术的罕见并发症。发病率和决定因素尚不清楚,然而,由于操作困难或使用过氧化氮,发病率更高。治疗方法可以是保守或手术,根据病变和患者的特征,因此医学法律利益的结果可能不同。
    这是一个关于一名70岁妇女的医疗责任案件,在插管过程中,向右猛扑。此外,一氧化二氮被用作麻醉剂。手术几小时后,患者在脸的右半部分和颈部的右侧区域表现出肿胀。紧急胸部CT扫描突出了皮下气肿和纵隔气肿。在手术室里,用双腔支气管进行纤维支气管镜检查,证实了假设病变;然后,对右后外侧开胸手术进行了全面治疗,然后缝合了气管病变。随后,患者在良好的临床状况下出院,但在右半胸部区域有疤痕。
    医源性气管损伤是经气管插管手术的一种罕见且可怕的并发症。尽管已经认识到增加其发作概率的风险因素,在大多数情况下,不可能确定原因。从医学法律的角度来看,气管插管后的损伤是不可预测和不可避免的,因此,在报告的案件中,决定采取和解解决方案。
    UNASSIGNED: Tracheal injury may be a rare complication of the endotracheal intubation procedure. Incidence and determinant factors are not well known, nevertheless a greater incidence have been recognized with a difficult maneuver or the use of nitrogen peroxide. The therapeutic approach can be conservative or surgical, depending on the characteristics of the lesion and of the patient and therefore the outcomes of medico-legal interest can be different.
    UNASSIGNED: It is a case of alleged medical liability regarding a 70-year-old woman, that during the intubation procedure was pouncing on the right. Furthermore, nitrous oxide was used as an anaesthetic. A few hours after the operation the patient showed swelling on the right half of the face and on the right lateral region of the neck. The emergency chest CT scan highlighted subcutaneous emphysema and pneumomediastinum. In the operating room, fibrobronchoscopy was performed with a double-lumen bronchial tube which confirmed the hypotheses lesion; then, right posterolateral thoracotomy was perfor-med followed by suturing of the tracheal lesion. Subsequently, the patient was discharged in good clinical conditions but with a scar in the region of the right hemithorax.
    UNASSIGNED: Iatrogenic tracheal injury is a rare and fearful complication of the orotracheal intubation procedure. Although risk factors that increase the probability of its onset have been recognized, in most cases it is not possible to identify the cause. From a medico-legal point of view, tracheal injury after intubation is unpredictable and inevitable, so in the case reported it was decided to proceed with a conciliatory solution.
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  • 文章类型: Journal Article
    从立法的角度来看,医疗是指提供服务,然而,医务人员的法律责任问题,这是在侵犯患者权利的情况下实施的,是相当困难的,其特点是有争议的评估点。今天,大量患者投诉医生,需要主管当局的考虑。文章认为民事的特点,行政和刑事责任适用于医务人员。
    From the point of view of legislation, medical care refers to the provision of services, however, the issues of legal responsibility of a medical worker, which is imposed in case of violation of the rights of a patient, are quite difficult and are characterized by controversial points for assessment. Today, a large number of complaints from patients are filed against doctors, requiring consideration by the competent authorities. The article considers the features of civil, administrative and criminal liability applied to medical workers.
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  • 文章类型: Journal Article
    在过去的几十年里,我们的医疗保健系统正在进行转型,更多地使用传感器进行远程护理和人工智能(AI)工具。特别是,通过具有学习能力的新算法改进的传感器已经证明了它们对更好的病人护理的价值。传感器和人工智能系统不再只是非自主设备,例如放射学或手术机器人中使用的设备;有一些具有一定程度自主性的新型工具旨在在很大程度上调节医疗决策。因此,在某些情况下,医生是做出决定并拥有最终决定权的人,而在其他情况下,医生可能仅应用由自主设备提供的决定。因为这是两种截然不同的情况,他们不应该被同样的对待,应适用不同的责任规则。尽管人们对传感器和人工智能在医学中的应用非常感兴趣,医生和病人都不愿意使用它。一个重要原因是缺乏明确的责任定义。没有人想犯错,甚至被起诉,因为他们遵循了人工智能系统的建议,特别是当它还没有完全适应一个特定的病人。即使使用简单的传感器和AI,也存在恐惧,例如在基于非常有用的远程医疗访问期间,临床相关传感器;有丢失重要参数的风险;以及,当然,当AI出现“智能”时,有可能取代医生的判断。本文旨在概述健康专业人员在远程医疗保健中使用传感器和AI工具的责任,分析四种制度:基于合同的方法,基于违反告知义务的方法,基于故障的方法,以及与善本身相关的方法。我们还将讨论传感器和人工智能在医学中的应用这一领域的未来挑战和机遇。
    In the last few decades, there has been an ongoing transformation of our healthcare system with larger use of sensors for remote care and artificial intelligence (AI) tools. In particular, sensors improved by new algorithms with learning capabilities have proven their value for better patient care. Sensors and AI systems are no longer only non-autonomous devices such as the ones used in radiology or surgical robots; there are novel tools with a certain degree of autonomy aiming to largely modulate the medical decision. Thus, there will be situations in which the doctor is the one making the decision and has the final say and other cases in which the doctor might only apply the decision presented by the autonomous device. As those are two hugely different situations, they should not be treated the same way, and different liability rules should apply. Despite a real interest in the promise of sensors and AI in medicine, doctors and patients are reluctant to use it. One important reason is a lack clear definition of liability. Nobody wants to be at fault, or even prosecuted, because they followed the advice from an AI system, notably when it has not been perfectly adapted to a specific patient. Fears are present even with simple sensors and AI use, such as during telemedicine visits based on very useful, clinically pertinent sensors; with the risk of missing an important parameter; and, of course, when AI appears \"intelligent\", potentially replacing the doctors\' judgment. This paper aims to provide an overview of the liability of the health professional in the context of the use of sensors and AI tools in remote healthcare, analyzing four regimes: the contract-based approach, the approach based on breach of duty to inform, the fault-based approach, and the approach related to the good itself. We will also discuss future challenges and opportunities in the promising domain of sensors and AI use in medicine.
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  • 文章类型: Journal Article
    目标:随着自然灾害变得更加频繁和严重,受影响国家通过志愿者迅速扩大其应对能力和促进恢复的能力变得越来越重要。然而,可能通过志愿者促进或阻碍增加的法律环境尚未得到充分探索。
    方法:本研究利用政策监督方法,使用紧急法律清单数据库和Westlaw对搜索中确定的相关法律进行编码。
    方法:我们评估了三个自然灾害多发州的法律:北卡罗来纳州,南卡罗来纳州,和格鲁吉亚。
    方法:我们评估了责任保护的存在,许可互惠,以及医疗保健志愿者的执业法律范围。
    结果:在三个评估的法律领域中,所有州的医疗保健志愿者的责任保护包含最有力的语言。责任保护适用,除非医疗保健志愿者鲁莽无视,故意的不当行为,或重大过失。然而,细微差别存在于哪些组织(州与慈善)志愿者有资格获得保险。进入受影响州的州外特定医疗保健专业人员的许可互惠在所有三个州都可用。然而,只有佐治亚州颁布了联邦示范立法,在证书和责任保护方面提供了额外的灵活性。最后,很少有法律涉及受影响州的实践范围。
    结论:对影响卫生保健志愿者应对和从灾难中恢复的能力的法律的比较很少。需要进行更多的研究,以更好地了解在紧急情况下影响志愿者的法律,特别是公共卫生系统在向受影响的社区提供服务时任务过度。
    OBJECTIVE: As natural disasters become more frequent and severe, the ability of impacted states to rapidly scale up their capacity to respond and facilitate recovery through volunteers is ever more crucial. However, the legal landscape that may facilitate or hamper augmentation through volunteers has yet to be fully explored.
    METHODS: This study utilized policy surveillance methodology to code relevant laws identified in searches using the Emergency Law Inventory database and Westlaw.
    METHODS: We assessed laws in three natural disaster-prone states: North Carolina, South Carolina, and Georgia.
    METHODS: We assessed the presence of liability protection, license reciprocity, and scope of practice laws for health care volunteers.
    RESULTS: Of the three assessed legal domains, liability protection for health care volunteers across all states contained the most robust language. Liability protections apply unless the health care volunteers act with reckless disregard, willful misconduct, or gross negligence. However, nuance exists based on which organizations (state vs charitable) volunteers are affiliated with to qualify for coverage. License reciprocity for out-of-state specific health care professions entering the impacted states was available across all three states. However, only Georgia enacted federal model legislation that provides additional flexibility regarding credentialing and liability protections. Lastly, very few laws addressed the scope of practice in impacted states.
    CONCLUSIONS: Comparisons of laws that impact the ability of health care volunteers to respond and recover from disasters are scarce. More research needs to be performed to better understand the laws that impact volunteers in emergencies, particularly as the public health system is overtasked when providing services to impacted communities.
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