Anesth Pain Med.  2020 Jan;15(1):96-102. 10.17085/apm.2020.15.1.96.

Dispute cases related to pain management in Korea: analysis of Korea Medical Dispute Mediation and Arbitration Agency data

• Lee JH
• Song J
• Kuk YH
• Ha JR
• Kim YD

• KMID: 2500462
• DOI: http://doi.org/10.17085/apm.2020.15.1.96

Abstract

Background
Various developments in imaging techniques, interventional procedures, and medications for pain management have beneficial consequences. However, the nature of pain management often results in physicians becoming involved in medico-legal disputes with patients who purposely or accidentally bring litigation.
Methods
Data on medical disputes cases related to pain management were collected and analyzed through the Korea Medical Dispute Mediation and Arbitration Agency from 2012 to 2016.
Results
In total, we identified 210 public-disclosed cases; of these, we identified 36 cases related to pain management. The department of orthopedics (n = 9, 25%) was the most related to these pain management cases. Pain management was most commonly offered for pain in the lumbar region (n = 13, 37%), lower extremities (n = 12, 34%), and for infection (n = 7, 19%). The time spent resolving disputes ranged from 8.0 to 17.5 months and the final settlement amount ranged from 1,800,000 to 15,000,000 Korean won. Causal relationships and medical malpractice were the most common controversial subjects of legal debate.
Conclusions
Various characteristics of medical disputes related to pain management in Korea were identified. Information regarding medical disputes in pain management should be available to help prevent further disputes and litigation, which is also useful to both patients and pain physicians. Guidelines and recommendations for pain management are needed, especially those focused on medico-legal cases.

Keyword

Compensation and redress; Complications; Dissent and disputes; Pain management; Wounds and injuries

Figure

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  Fig. 1 Classification of cases by the body part.

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  Fig. 2 Classification of cases by contents and severity.

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  Fig. 3 Median time spent resolving medical disputes by the contents.

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  Fig. 4 Final median amount of agreement on a medical dispute.

Reference

Kim KH., Choi JW., Lee ES. 2015. The state of medical malpractice caused by private practice physicians (2010-2012): analysis through incident reports at Korean Medical Association Medical Indemnities Mutuals. J Korean Med Assoc. 58:336–48. DOI: 10.5124/jkma.2015.58.4.336.

Lee JC., Min HY., Kim KH., Kim HN. 2010. Factors associated with the malpractice settlement cost between doctors and patients in Korea. Health Soc Sci. 28:171–96.

Wilcox CE., Mayer AR., Teshiba TM., Ling J., Smith BW., Wilcox GL, et al. 2015. The subjective experience of pain: an FMRI study of percept-related models and functional connectivity. Pain Med. 16:2121–33. DOI: 10.1111/pme.12785. PMID: 25989475. PMCID: PMC4653099.

Lee IH., Lee IO. 2005. Questionnaire study about responsible parties in medical malpractice. Korean J Med Law. 13:63–70.

Stewart RM., Johnston J., Geoghegan K., Anthony T., Myers JG., Dent DL, et al. 2005. Trauma surgery malpractice risk: perception versus reality. Ann Surg. 241:969–75. DOI: 10.1097/01.sla.0000164179.48276.45. PMID: 15912046. PMCID: PMC1357176.

Kim YD., Moon HS. 2015. Review of medical dispute cases in the pain management in Korea: a medical malpractice liability insurance database study. Korean J Pain. 28:254–64. DOI: 10.3344/kjp.2015.28.4.254. PMID: 26495080. PMCID: PMC4610939.

Bae HA., Noh H., Jang HY., Jung KY. 2007. Medicolegal consideration of acute appendicitis: based on judicial precedents. J Korean Surg Soc. 72:223–9.

Kwak JY., Choi KR., Jun RM., Han KE. 2018. Medical litigations associated with cataract surgery in Korea. J Korean Med Sci. 33:e180. DOI: 10.3346/jkms.2018.33.e180. PMID: 29962925. PMCID: PMC6021357.

Lee ES., Oh JY., Cho HS., Kim KH., Lee SD., Kim KS, et al. 2014. Study about the status and prevention of oriental medical disputes. J Korean Orient Med. 35:58–67. DOI: 10.13048/jkm.14006.

Korea Consumer Agency. 2015. Consumer’s damage cases year and case book 2014. Korean Consumer Agency;Eumseong: p. 293.

Kim SC. 2003. Alternative resolving medical malpractice disputes on the consumer protection laws. Korean Med Assoc. 44–53.

Korean Consumer Agency. 2011. Annual report on consumer redress and casebook 2010. . Korean Consumer Agency;Eumseong:

Park EJ., Han KR., Kim DW., Kim C. 2007. A clinical survey of the patients in neuro-pain clinic at Ajou university. Korean J Pain. 20:181–5. DOI: 10.3344/kjp.2007.20.2.181.

Lee W., Lee MJ., Kim YM., Woo CM., Kim SY., Kim YS. 2016. A study on the current status of medical lawsuits in orthopedics in Korea. J Korean Orthop Assoc. 51:246–54. DOI: 10.4055/jkoa.2016.51.3.246.

Shin DA., Kim ES., Rhim SC. 2009. Review of preoperative conservative treatment period and evidence of surgeries for herniated lumbar disc. Korean J Spine. 6:111–23.

Asian Institute for Bioethics and Health Law. 2009. Research on medical malpractice prevention programs for foreign patients. . Korea Health Industry Development Institute;Cheongju:

Fitzgibbon DR., Posner KL., Domino KB., Caplan RA., Lee LA., Cheney FW. 2004. Chronic pain management: American Society of Anesthesiologists Closed Claims Project. Anesthesiology. 100:98–105. DOI: 10.1097/00000542-200401000-00018. PMID: 14695730.

Fitzgibbon DR., Rathmell JP., Michna E., Stephens LS., Posner KL., Domino KB. 2010. Malpractice claims associated with medication management for chronic pain. Anesthesiology. 112:948–56. DOI: 10.1097/ALN.0b013e3181cdef98. PMID: 20234314.