Ann Surg Treat Res.  2016 Dec;91(6):316-322. 10.4174/astr.2016.91.6.316.

Legal issues related to postoperative pulmonary thromboembolism in Korea

• Park BY
• Kim MJ
• Kang SR
• Hong SE

• KMID: 2360392
• DOI: http://doi.org/10.4174/astr.2016.91.6.316

Abstract

PURPOSE
Currently, development of pulmonary thromboembolism (PTE) after surgery is frequently being followed by legal action in Korea, as consequences may be fatal. In the current study, we assessed possible countermeasures that medical teams can take when faced with conflicting opinions on responsibility for PTE.
METHODS
A retrospective analysis of claims handled by the Supreme Court and subordinate courts, from 1999 to 2015, was performed. We analyzed the type of procedure, associated complications, and critical legal points from the recorded judgments along with any liability limitations on surgeons.
RESULTS
After reviewing cases between 1999 and 2015, a total of 18 cases were analyzed. There were no cases in which the surgeon was held accountable between 1999 and 2002. From 2003, there were instances of the surgeon being held accountable, with a peak of cases in 2013. Legal standards applied in judicial decision-making related to appropriate use of preventive measures, operation characteristics, doctor's reaction towards symptom occurrence, obligation of postoperative medical care, and duty of explanation.
CONCLUSION
The courts in Korea have changed their position from one of denying doctors' liability to one of enforcing responsibility for PTE. Surgeons are therefore being held responsible with greater frequency, depending on the details of the case. Lessons can be learnt from precedents that can be incorporated into medical education and training programs with the aim of reducing both major PTE complication rates and litigation costs.

Keyword

Surgery; Pulmonary embolism; Malpractice; Jurisprudence

MeSH Terms

Education
Education, Medical
Judgment
Jurisprudence
Korea*
Malpractice
Pulmonary Embolism*
Retrospective Studies
Surgeons

Figure

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  Fig. 1 Distribution of surgery procedures in malpractice claims.

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  Fig. 2 Distribution of complications after diagnosis of pulmonary thromboembolism that mainly concerned medical lawsuits.

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  Fig. 3 Initial clinical manifestations before diagnosis of pulmonary thromboembolism. Distribution of surgery procedures in malpractice claims.

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  Fig. 4 Yearly distribution of courts' judgments in pulmonary thromboembolism-related plastic surgery malpractice claims.

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  Fig. 5 Yearly distribution of surgeons' ranges of liability (percent).

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  Fig. 6 Legal standards for findings of liability for surgeons in a final declaration of malpractice claims.

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  Fig. 7 Legal standards for findings of nonliability for surgeons in a final declaration of malpractice claims. PTE, pulmonary thromboembolism.

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