Malpractice claims and unintentional outcome of tonsil surgery and other standard procedures in otorhinolaryngology.

摘要: Background: Septoplasty, tonsillectomy (with and without adenoidectomy) cervical lymph node excision are amongst the most common 50 inpatient operations in Germany. Intracapsular tonsillectomies (i.e. tonsillotomies) increasingly performed. The aim of this study was to evaluate technical traps pitfalls as well alleged medical malpractice associated with (TE), adenoidectomy (AE), tonsillotomy (TT), septoplasty (SP) (LN). Methods: A questionnaire sent Regional Medical Conciliation Boards, Services Health Insurance Companies (MDK) Institutes Forensic Medicine Germany collect anonymized cases complications following TE, TT, AE, LN SP. results were discussed light contemporary literature published trials verdicts Results: response rate our survey 55.9%. contributed nine cases, 49 submitted by Boards none MDK. All forensic exsanguinations including two children (5 8 years age) seven adults (aged 20 69 years). fatal post-tonsillectomy hemorrhage (PTH) had occurred 8.7 days on average; four patients experienced bleeding episode at home (day 5, 8, 9 17, respectively). Repeated episodes requiring surgical intervention 6 patients. Three decicions TT (1), AE (4), (3), SP (16) TE (25). Cases lethal outcome not registered. Only three assessed (6.1%) lesion spinal accessory nerve, wrong indication for dental after insertion mouth gag. review medico legal yielded 71 (29), (28) (14) which 37 resulted compensation (16; 57%), (10; 37%), (8; 57%) (2; 100%). There 16 PTH 27 resulting either death (5) or apallic syndrome (5). Bleeding day surgery only 2 based claims encompassing lack informed consent (6), anosmia septal perforation (2), frontobasal injury (2) dry nose (2). Trials procedures exclusively a nerve (28), 19 cases. (69%) decided defendant, 22 (31%) plaintiff monetary 7 29 AE/TE-trials, 28 LN-trials 14 SP-trials. Lack registered AE/TE but (11) Conclusion: Complicated ATE, systematically collected It can be assumed, that every complicated case is law journals therefore obtainable scientific research. Alleged malpracice proven less than 6% before trial stage. Approximately half all result verdict settlement court. Proper documentation thourough counselling, examination, indication, follow-up assists surgeon litigation. An adequate complication management essential, instructions patients/parents, staff readily available instruments. Successful life-threatening widely proper airway an interdisciplinary approach. Electrosurgical techniques repeatedly labeled risk factor TE. Institutions should analyse individual yearly basis. Contradictory expert opinions courts concerning accesory lesions due standard.