Korean J Anesthesiol.  2017 Apr;70(2):188-195. 10.4097/kjae.2017.70.2.188.

Analysis of medical disputes regarding chronic pain management in the 2009–2016 period using the Korean Society of Anesthesiologists database

• Lee JY
• Kim DK
• Jung DW
• Yang JY
• Kim DY

• KMID: 2377420
• DOI: http://doi.org/10.4097/kjae.2017.70.2.188

Abstract

BACKGROUND
The active involvement of anesthesiologists in chronic pain management has been associated with an increase in the number of related medical dispute cases.
METHODS
Using the Korean Society of Anesthesiologists Legislation Committee database covering case files from July 2009 to June 2016, we explored injuries and liability characteristics in a subset of cases involving chronic pain management.
RESULTS
During the study period, 58 cases were eligible for final analysis. There were 27 cases related to complex regional pain syndrome (CRPS), many of them involving problems with financial compensation (24/27, 88.9%). The CRPS cases showed male dominance (22 males, 5 females). In a disproportionately large number of these cases, the causative injury occurred during military training (n = 5). Two cases were associated with noninvasive pain managements, and 29 cases with invasive procedures. Of the latter group, procedures involving the spine (both neuraxial and non-neuraxial procedures) resulted in more severe complications than other procedures (P = 0.007). Seven of the patients who underwent invasive procedures died. The most common type of invasive procedures were lumbosacral procedures (16/29, 55.2%). More specifically, the most common damaging events were inadvertent intravascular or intrathecal injection of local anesthetics (n = 6).
CONCLUSIONS
Several characteristics of medical disputes related to chronic pain management were identified: the prevalence of injury benefit claims in CRPS patients, higher severity of complications in procedures performed at the spine or cervical region, and the preventability of inadvertent intravascular or intrathecal injection of local anesthetics.

Keyword

Chronic pain; Complications; Malpractice; Medical legislation

MeSH Terms

Anesthetics, Local
Chronic Pain*
Compensation and Redress
Dissent and Disputes*
Humans
Injections, Spinal
Legislation, Medical
Male
Malpractice
Military Personnel
Pain Management
Prevalence
Spine
Anesthetics, Local