Analysis of endotracheal intubation-related judicial precedents in South Korea.

Airway management Complications Emergency care endotracheal intubation Legislation and jurisprudence Medical liability

Journal

Korean journal of anesthesiology
ISSN: 2005-7563
Titre abrégé: Korean J Anesthesiol
Pays: Korea (South)
ID NLM: 101502451

Informations de publication

Date de publication:
12 2021
Historique:
received: 17 01 2021
accepted: 21 03 2021
pubmed: 25 3 2021
medline: 8 1 2022
entrez: 24 3 2021
Statut: ppublish

Résumé

Medical malpractice during endotracheal intubation can result in catastrophic complications. However, there are no reports on these severe complications in South Korea. We aimed to investigate the severe complications associated with endotracheal intubation occurring in South Korea, via medicolegal analysis. We retrospectively analyzed the closed judicial precedents regarding complications related to endotracheal intubation lodged between January 1994 and June 2020, using the database of the Supreme Court of Korea. We collected clinical and judicial characteristics from the judgments and analyzed the medical malpractices related to endotracheal intubation. Of 220 potential cases, 63 were included in the final analysis. The most common event location was the operating room (n = 20, 31.7%). All but 3 cases were associated with significant permanent or more severe injury, including 31 deaths. The most common problems were failed or delayed intubation (n = 56, 88.9%). Supraglottic airway device was used in 5.2% (n = 3) cases of delayed or failed intubation. Fifty-one (81%) cases were ruled in favor of the plaintiff in the claims for damages, with a median payment of Korean Won 133,897,845 (38,000,000, 308,538,274). The most common malpractice recognized by the court was that of not attempting an alternative airway technique (n = 32, 50.8%), followed by violation of the duty of explanation (n = 10, 15.9%). Our results could increase physicians' awareness of the major complications related to endotracheal intubation and help ensure patient safety.

Sections du résumé

BACKGROUND
Medical malpractice during endotracheal intubation can result in catastrophic complications. However, there are no reports on these severe complications in South Korea. We aimed to investigate the severe complications associated with endotracheal intubation occurring in South Korea, via medicolegal analysis.
METHODS
We retrospectively analyzed the closed judicial precedents regarding complications related to endotracheal intubation lodged between January 1994 and June 2020, using the database of the Supreme Court of Korea. We collected clinical and judicial characteristics from the judgments and analyzed the medical malpractices related to endotracheal intubation.
RESULTS
Of 220 potential cases, 63 were included in the final analysis. The most common event location was the operating room (n = 20, 31.7%). All but 3 cases were associated with significant permanent or more severe injury, including 31 deaths. The most common problems were failed or delayed intubation (n = 56, 88.9%). Supraglottic airway device was used in 5.2% (n = 3) cases of delayed or failed intubation. Fifty-one (81%) cases were ruled in favor of the plaintiff in the claims for damages, with a median payment of Korean Won 133,897,845 (38,000,000, 308,538,274). The most common malpractice recognized by the court was that of not attempting an alternative airway technique (n = 32, 50.8%), followed by violation of the duty of explanation (n = 10, 15.9%).
CONCLUSIONS
Our results could increase physicians' awareness of the major complications related to endotracheal intubation and help ensure patient safety.

Identifiants

pubmed: 33761583
pii: kja.21020
doi: 10.4097/kja.21020
pmc: PMC8648513
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

506-513

Commentaires et corrections

Type : CommentIn

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Auteurs

Hye-Yeon Cho (HY)

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

SuHwan Shin (S)

Department of Medical Law and Ethics, Graduate School, Yonsei University, Seoul, Korea.

SangJin Lee (S)

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

Susie Yoon (S)

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.

Ho-Jin Lee (HJ)

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.

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