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      Professional Liability in Plastic Surgery: A Change of Scenario in Medical Professional Liability in Spain

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          Background:

          The epidemic of complaints and/or litigation, both in and out of court, for cases of alleged malpractice has increased dramatically. In Spain, claims related to plastic surgery are gaining more and more interest.

          Methods:

          The Council of Medical Associations of Catalonia database was used to analyze claims related to plastic surgery from 1986 to 2021.

          Results:

          1039 claims (9.8% over 10,567 total claims) were studied. Both the total number of claims ( P = 0.016; R 2=0.16) and the number of claims for plastic surgery ( P < 0.0005; R 2=0.732) showed an upward trend during the period of study. In the period from 2000 to 2021, the behavior was different; while the number of total claims stabilized ( P = 0.352; R 2 = 0.043), plastic surgery claims continued to show a time-related tendency to increase ( P < 0.0005; R 2=0.484). The distribution was 50.12% out of court. Ten unique procedures accounted for 84.5% of the total number of claims. Liability was observed in 21.46% of the closed claims, with differences between civil (20.34%), criminal (6.89%), and out-of-court (25.53%) procedures. Regarding compensation amounts, out-of-court cases had an average of 33,169.44 euros paid; civil cases, 29,153.37 euros; and criminal cases, 37,186.88 euros.

          Conclusions:

          The increase in the number of cases can only be related to an increase in the activity carried out by plastic surgeons. There has been a change in Spain in terms of the most sought-after medical specialty, with plastic surgery having displaced the perennially most sought-after specialty, orthopedic surgery and traumatology.

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          Most cited references21

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          Malpractice risk according to physician specialty.

          Anupam Jena, Seth A Seabury, Darius Lakdawalla … (2011)
          Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty. We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties. Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic-cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties. There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.).
          Article 0 comments Cited 196 times – based on 0 reviews     Review now
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            Plastic Surgery and the Malpractice Industry.

            J Brian Boyd, Harry K Moon, Susan Martin … (2021)
            The current status of the plastic surgeon in the medical liability spectrum and ways to avoid litigation are explored by using pooled national data from the Medical Professional Liability Association, private information from Applied Medico-Legal Solutions RRG, and a detailed literature search. The medical liability system in the United States costs $55.6 billion, or 2.4 percent of total health care spending. Plastic surgery accounts for 3.31 percent of reported claims and 3.16 percent of paid claims. Total payments for plastic surgeons represent 1.75 percent of the total paid for all specialties. Malpractice awards are relatively light for plastic surgeons. Nevertheless, they still have a 15 percent chance per year of being sued. However, 93 percent of cases will close with a dismissal or a settlement, and only 7 percent will go to trial. Of these, the plastic surgeon will prevail in 79 percent. Most importantly, 75 percent of all cases will result in no payment. To minimize the chances of a lawsuit, plastic surgeons should maintain excellent communication with their patients and participate in shared decision-making. They should take a leadership role and buy in to the performance of perioperative checklists, embrace patient education, and actively participate in Maintenance of Certification. They should be transparent in their dealings with patients by preoperatively declaring their policies on revisions, refunds, complications, and payments. Plastic surgeons must maintain complete and accurate medical records and participate in hospital-based programs of prophylaxis. They should be aware that postoperative infection is the single costliest adverse outcome and proactively deal with it.
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              Medical malpractice and legal medicine.

              S. Ferrara (2013)
              Article 0 comments Cited 7 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Plast Reconstr Surg Glob Open
                Journal ID (iso-abbrev): Plast Reconstr Surg Glob Open
                Journal ID (publisher-id): GOX
                Title: Plastic and Reconstructive Surgery Global Open
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Electronic): 2169-7574
                Publication date Collection: June 2023
                Publication date (Electronic): 09 June 2023
                Volume: 11
                Issue: 6
                Electronic Location Identifier: e5054
                Affiliations
                From the [* ]Professional Liability Department, Barcelona’s College of Physicians, Barcelona, Spain
                [† ]Chair of Professional Liability and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
                [‡ ]Department of Medicine and Life Sciences (MELIS). Universitat Pompeu Fabra, Barcelona, Spain
                [§ ]Plastic and Reconstructive Surgery Service Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
                []Quirurgia, Barcelona, Spain.
                Author notes
                Carles Martin-Fumadó, MD, PhD, Professional Liability Service, College of Physicians of Barcelona, Passeig Bonanova, 47. 08017, Barcelona, Spain, E-mail: carles.martin@ 123456comb.cat
                Article
                Accession ID: 00010
                DOI: 10.1097/GOX.0000000000005054
                PMC ID: 10256378
                SO-VID: b1d3227a-1ddf-483f-97db-d8340f2f0887
                Copyright © Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                Date received : 2 February 2023
                Date accepted : 13 April 2023
                Categories
                Subject: Business
                Subject: Original Article
                Custom metadata
                OPEN-ACCESS TRUE
                COUNTRY SPAIN

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