J Korean Med Sci.  2015 Feb;30(2):207-213. 10.3346/jkms.2015.30.2.207.

Analysis of Anesthesia-related Medical Disputes in the 2009-2014 Period Using the Korean Society of Anesthesiologists Database

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, School of Medicine, The Catholic University of Daegu, Daegu, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dikei@hanmail.net
  • 3Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea.
  • 4Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 5Department of Anesthesiology and Pain Medicine, College of Medicine, Dong-A University, Busan, Korea.
  • 6Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
  • 7Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University, Daegu, Korea.

Abstract

Using the Korean Society of Anesthesiologists database of anesthesia-related medical disputes (July 2009-June 2014), causative mechanisms and injury patterns were analyzed. In total, 105 cases were analyzed. Most patients were aged < 60 yr (82.9%) and were classified as American Society of Anesthesiologists physical status < or = II (90.5%). In 42.9% of all cases, the injuries were determined to be 'avoidable' if the appropriate standard of care had been applied. Sedation was the sec most common type of anesthesia (37.1% of all cases), following by general anesthesia. Most sedation cases (27/39, 69.2%) showed a common lack of vigilance: no pre-procedural testing (82.1%), absence of anesthesia record (89.7%), and non-use of intra-procedural monitoring (15.4%). Most sedation (92.3%) was provided simultaneously by the non-anesthesiologists who performed the procedures. After the resulting injuries were grouped into four categories (temporary, permanent/minor, permanent/major, and death), their causative mechanisms were analyzed in cases with permanent injuries (n=20) and death (n=82). A 'respiratory events' was the leading causative mechanism (56/102, 54.9%). Of these, the most common specific mechanism was hypoxia secondary to airway obstruction or respiratory depression (n=31). The sec most common damaging event was a 'cardiovascular events' (26/102, 25.5%), in which myocardial infarction was the most common specific mechanism (n=12). Our database analysis demonstrated several typical injury profiles (a lack of vigilance in seemingly safe procedures or sedation, non-compliance with the airway management guidelines, and the prevalence of myocardial infarction) and can be helpful to improve patient safety.

Keyword

Adverse Effects; Injuries; Legislation; Malpractice

MeSH Terms

Adult
Anesthesia, General/*adverse effects
Anoxia/epidemiology
Female
Humans
Male
*Malpractice
*Medical Errors
Middle Aged
Myocardial Infarction/epidemiology
Republic of Korea/epidemiology
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