Subjects

Treatment errors: definition, examples and help


Surgery is always a risk, and serious surgery can result in death. There is no such thing as absolute security in medicine, and some deaths cannot be avoided, as hard as this may sound to the bereaved. It is different when doctors make misdiagnoses and surgeons make mistakes, whether due to negligence or lack of qualifications. Or when doctors do not recognize life-threatening diseases or even criminals accept the death of patients.

Treatment errors are common

The Medical Service of the Federation of Health Insurance Companies identified 4,064 treatment errors in 2015. The AOK estimates the real malpractice at around 190,000 per year, and every tenth victim would die from it, according to the AOK. It cannot be proven whether treatment errors are more common today than in the past. However, the sensitivity of patients who report suspected errors to health insurers more and more has increased.

The medical responsibility

The medical profession demands an ever greater responsibility: doctors are still responsible for examinations, diagnosis and therapy. In addition, there is an overview of the increasingly complex devices, and the doctor is also liable if patients suffer from excessive radiation exposure, for example, because the devices are not kept in good condition.

Medical professionals also need to educate patients about the opportunities and risks of treatment and give them time to choose.

When is the doctor liable?

A doctor is liable for improper, incorrect, or inappropriate treatment. There are, however, exceptions that are historically determined and enforced by lobbying interests: In particular, the last definition (not according to the state of scientific knowledge) also applies to homeopathy, for example, and yet many doctors - due to their conviction of the effect - lead homeopathic “ Treatments ”.

A complication after an operation, a poor healing process, ineffective medication, all of this does not have to be a treatment error. This is only the case if an inadequate, omitted, inadequate or improper treatment of a patient has been shown to cause damage.

"Trial and error" is also not necessarily a treatment error. With countless illnesses, symptoms overlap. Dizziness, for example, can also be caused by a vitamin D deficiency as well as in diseases of the brain, a flu-like infection, diseases of the inner ear such as the cervical spine and, last but not least, psychological problems.

A doctor who educates patients about the possible causes does not act negligently once they address a possible cause, the treatment of which has few side effects, to see whether the symptoms stop or persist.

Improper treatment can also be due to the fact that a patient suffers from a very rare illness, the symptoms of which correspond to widespread complaints. Then it is a treatment error, but not necessarily the negligence of the doctor.

The question here is: can and should the respective doctor be informed about this clinical picture? If so, he is negligent because he does not recognize the illness. If not, then not.

Various disease patterns are in a border area, which means that the latest research is far from being known to every practitioner.

Simple and gross mistakes

Treatment errors are made by the doctor in all dealings with patients: diagnosis, treatment, advice, medication or transport.

Delaying a diagnosis can be just as much a mistake as a wrong diagnosis, a failure to recognize the patient's right, the refusal of treatment, an inappropriately timed clarification, an incomplete clarification of the content and an error in the finding of the finding.

In the case of a simple treatment error, the patient must prove the error, but in the case of a gross error, the doctor must prove that he is innocent.

Gross mistakes are defined as actions that appear irresponsible from an objective medical point of view, because a trained doctor should not make such a mistake.

From a legal point of view, there is a treatment error if, on the one hand, a demonstrably wrong action by the doctor leads, on the other hand, to damage to the patient, which, thirdly, is due to this wrong action.

A treatment error that has no consequences for the patient is therefore legally irrelevant.

Treatment errors initially have civil law consequences, namely compensation for damages and compensation for the injured. If it is negligence and the resulting negligent bodily harm or negligent homicide or missing or insufficient information and thus bodily harm, the medical practitioner can expect criminal consequences.

Guilt or innocence?

The doctor is not to blame for every treatment error. A medical doctor is not responsible if, to the best of his knowledge and belief, he uses methods of his time that later prove to be harmful.

For example, there was no guilt for doctors who in centuries past infected patients with deadly diseases because nobody knew about bacteria and viruses and disinfection and sterility were unknown.

However, doctors are guilty to the full extent who, on purpose or negligence, make mistakes in treatments that are part of the usual practice of their profession: a surgeon who pulls a simple suture so uncleanly that the wound becomes infected, a dentist who has a large hole overlooks or a medical professional who prescribes a blood flow stimulant to a patient with heavy bleeding injuries.

It is also a treatment error if the therapy is successful, but milder methods are up-to-date, for example if a dentist pulls a molar tooth with caries even though it could have filled the hole.

It is not a medical error if a doctor carries out a new and risky operation - with full information and with the consent of a patient who would inevitably kill a disease without help.

This applies, for example, to early heart transplants, in which the immune system of the operated surgeon rejected the foreign heart and the patient died after a short time.

Causes of treatment errors

1) Revision: Medical personnel in clinics work under great time pressure, which is why volatile mistakes are inevitable. Emergency and accident doctors have to make decisions in seconds that can mean death or life.

2) Vanity: Some doctors cultivate the nimbus of the omniscient towards patients and do not dare to say "I know the cause of their complaints". Or they are too vain to admit a wrong diagnosis and do not correct them. Or they know that a colleague could treat the disease better than they do, but they don't tell the patient.

3) ignorance: Doctors often treat illnesses incorrectly because they have no idea of ​​the actual illness. Negligence is always present if they could have this knowledge and, for example, would be obliged to attend further training but do not do so.

4) Routine: Surgery, which usually runs without problems, can cause an experienced surgeon to avoid paying attention to complications with the same level of attention as an operation that he considers to be risky. If serious problems arise, he may not recognize them until it is too late.

5) Lack of experience: No master has yet fallen from the sky, an old saying goes, and doctors also learn from practice in medicine.

6) Wrong belief: A healer can be so convinced of a scientifically refuted method that he implements it because he is convinced that it works.

7) Greed for profit: It is also wrong treatment if a doctor leaves a patient in hospital for longer than necessary without a medical reason, prescribes lengthy therapies, even though he knows that they are unnecessary or prescribes expensive medicines, although there are cheap replacements.

Knife in the body

Jorge Alberto Gonzalez Campos from El Salvador was the victim of a robbery in 1995. One of the perpetrators stabbed him in the head with a knife. Gonzales came to a clinic and doctors treated the wound but thought they could not remove the blade.

They didn't tell the victim that the blade remained in the head. It wasn't until 12 years later that Gonzales felt a strange bulge in the skin and felt the shape of a blade. He went to see doctors, but they refused to operate on him.

It was only six years later that neurosurgeon Eduardo Lovo removed the knife from the body of the now 44-year-old man. The result was a nine centimeter blade that had grown into the left eye socket.

Canadian Bill McNeely came to a hospital after a fight. Doctors treated a wound in the back and sewed it up. A bump formed, the skin itched, and McNeely kept seeing doctors. They said that an injured nerve caused the pain, but did not design an X-ray.

McNeely then went to jail, and every time the guards searched for weapons with metal detectors, the devices sounded the alarm. One day he scratched his back and it sounded like metal.

His girlfriend decided. She saw the shape under the surface of the skin and said, "There's a knife in your back, Billy." A surgeon removed a seven centimeter blade from the Canadian's body a little later.

Woman dies because doctors think she is dead

In 2013, a 72-year-old woman suffered serious injuries. She had a traffic accident at Itzehoe. The doctors present diagnosed death.

The mortician was amazed later, because when he opened the body bag, the victim breathed. In the evening she died of head injuries.

If treated immediately, she would probably have survived.

Death after tonsillitis

Marijke was hospitalized in 2006 to have her tonsils removed, a simple operation. But after that, the doctors mis-injected oxygen, her stomach bulged, and the girl's legs turned blue.

The doctors performed an emergency operation to get the air out of her stomach and removed Marijke's appendix without ever having any problems with it.

The girl spat blood after the operation, and blood came from the incision in the abdomen that ran from the chest to the pubis.

At 10 p.m. she came to another clinic and was thoroughly examined there. The doctors found that she had severe lung and liver damage. She also had a hole in her stomach, which the doctors who did the emergency surgery had overlooked.

The doctors in the second hospital closed the hole in the stomach during another operation. Marijke fell into a coma and didn't wake up. On November 29th In 2006 she died at the age of 14.

The anesthetist at the first clinic received a charge of negligent homicide. The case is closed.

Cardiac arrest during cosmetic surgery

Carolin Wosnitza became known as "Sexy Cora" in porn films. She had already had some cosmetic surgery before she wanted to have her breast enlarged.

There was insufficient ventilation during the operation. The heart stopped and the young woman died. The device's warning tone was switched off.

The anesthetist received a suspended sentence of 14 months for negligent homicide. Wosnitza's pimp and widower received compensation for pain and suffering of almost 500,000 euros in April 2016.

The wrong leg amputated

Doctors in a hospital in Austria amputated the wrong leg of a 91-year-old woman in 2010. They noticed her mistake and also amputated her second leg.

The hospital released the doctor in charge.

Misdiagnosis for malicious intent

A Dutch doctor diagnosed about 200 people with serious diseases such as multiple sclerosis, Alzheimer's or dementia, although tests did not confirm the diagnoses.

The judges ruled that he "consciously and deliberately" made the wrong diagnoses. In 2014, the fraudster received three years' imprisonment without parole.

What can patients do?

Healers often misdiagnose from specialist blindness: a neurologist will first look for nerve disorders in the case of a headache, an expert in psychosomatic illnesses for psychological problems, a physiotherapist may suspect tense neck muscles.

Patients are well advised to inform themselves, for example via internet portals, and should always ask their doctor which diseases could still be considered.

If you suffer from certain symptoms, you can keep a diary in which he or she describes in detail what happens and also notes what each doctor said about it.

If a treatment error is suspected, those affected can inform the health insurance company. If the health insurance company considers the suspicion to be justified, it will raise the matter with an expert from the Medical Service of Health Insurance (MDK). The doctor then assesses whether there may be a treatment error or whether there were complications that are not the responsibility of the doctor.

If there is reasonable suspicion, the MDK will prepare a scientific opinion, so that those affected can either reach an out-of-court settlement or bring an action. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch

Swell:

  • Federal Ministry of Health: Treatment errors (accessed: August 13, 2019), bundesgesundheitsministerium.de
  • Consumer center NRW e.V .: suspected treatment errors: You need to know that (access: 13.08.2019), verbraucherzentrale.de
  • Bundesärztekammer: Treatment error statistics (access: 13.08.2019), bundesaerztekammer.de
  • Majcher-Byell, Monika: Medical law: When doctors have to vouch for medical errors, Dtsch Arztebl, 2016, aerzteblatt.de
  • Deutsche Rentenversicherung Knappschaft-Bahn-See: Treatment errors (access: August 13, 2019), kurzschaft.de


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