The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

  • Kim, Yeon Dong (Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Moon, Hyun Seog (Department of Pain Medicine, MHS Interventional Pain Treatment Center)
  • Received : 2015.04.10
  • Accepted : 2015.08.27
  • Published : 2015.10.01
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Abstract

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

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References

  1. Sitzman BT. Adverse event protocol for interventional pain medicine: the importance of an organized response. Pain Med 2008; 9: S108-12. https://doi.org/10.1111/j.1526-4637.2008.00446.x
  2. Lee IH, Lee IO. Questionnaire study about responsible parties in medical malpractice. Korean J Med Law 2005; 13:63-70.
  3. Kwon MI. The types of medical accidents and strategies for prevention: focused in medical accidents occurred in anesthetic and surgical fields. Korean J Anesthesiol 2007; 53: 555-64. https://doi.org/10.4097/kjae.2007.53.5.555
  4. Choe H, Oh KH, Song JJ, Han YJ. Pain clinic 10 years at Chonbuk National University. J Korean Pain Soc 1995; 8:110-6.
  5. Park EJ, Han KR, Kim DW, Kim C. A clinical survey of the patients in neuro-pain clinic at Ajou University. Korean J Pain 2007; 20: 181-5. https://doi.org/10.3344/kjp.2007.20.2.181
  6. Shin DA, Kim ES, Rhim SC. Review of preoperative conservative treatment period and evidence of surgeries for herniated lumbar disc. Korean J Spine 2009; 6: 111-23.
  7. Kim JH. Current situation and related issues on medical malpractice: an approach form medical sociological perspective. Korean J Sociol 1998; 32: 395-426.
  8. Fitzgibbon DR, Posner KL, Domino KB, Caplan RA, Lee LA, Cheney FW; American Society of Anesthesiologists. Chronic pain management: American society of anesthesiologists Closed Claims Project. Anesthesiology 2004; 100: 98-105. https://doi.org/10.1097/00000542-200401000-00018
  9. Domino KB, Fitzgibbon DR. Clinical lessons in chronic pain management from the Closed Claims Project. ASA Newsl 2004; 68: 25, 27.
  10. Fitzgibbon DR, Rathmell JP, Michna E, Stephens LS, Posner KL, Domino KB. Malpractice claims associated with medication management for chronic pain. Anesthesiology 2010; 112: 948-56. https://doi.org/10.1097/ALN.0b013e3181cdef98
  11. Botwin KP, Sharma K, Saliba R, Patel BC. Ultrasound-guided trigger point injections in the cervicothoracic musculature: a new and unreported technique. Pain Physician 2008; 11:885-9.
  12. Narouze S, Benzon HT, Provenzano DA, Buvanendran A, De Andres J, Deer TR, et al. Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain. Reg Anesth Pain Med 2015; 40:182-212. https://doi.org/10.1097/AAP.0000000000000223
  13. Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF Secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation 2011; 124: 2458-73. https://doi.org/10.1161/CIR.0b013e318235eb4d
  14. Lehmann LJ, Pallares VS. Subdural injection of a local anesthetic with steroids: complication of epidural anesthesia. South Med J 1995; 88: 467-9. https://doi.org/10.1097/00007611-199504000-00018
  15. Lirk P, Kolbitsch C, Putz G, Colvin J, Colvin HP, Lorenz I, et al. Cervical and high thoracic ligamentum flavum frequently fails to fuse in the midline. Anesthesiology 2003; 99: 1387-90. https://doi.org/10.1097/00000542-200312000-00023
  16. Reina MA, de Leon-Casasola OA, Lopez A, De Andres J, Martin S, Mora M. An in vitro study of dural lesions produced by 25-gauge Quincke and Whitacre needles evaluated by scanning electron microscopy. Reg Anesth Pain Med 2000; 25: 393-402. https://doi.org/10.1097/00115550-200007000-00013
  17. Kim YD, Ham HD, Moon HS, Kim SH. Delayed pneumocephalus following fluoroscopy guided cervical interlaminar epidural steroid injection: a rare complication and anatomical considerations. J Korean Neurosurg Soc 2015; 57: 376-8. https://doi.org/10.3340/jkns.2015.57.5.376
  18. Friedman DI, Rausch EA. Headache diagnoses in patients with treated idiopathic intracranial hypertension. Neurology 2002; 58: 1551-3. https://doi.org/10.1212/WNL.58.10.1551
  19. Morain WD, Colen LB. Wound healing in diabetes mellitus. Clin Plast Surg 1990; 17: 493-501.
  20. Lee HK, Choi EJ, Lee PB, Nahm FS. Anaphylactic shock caused by the epidurally-administered hyalurinidase. Korean J Pain 2011; 24: 221-5. https://doi.org/10.3344/kjp.2011.24.4.221
  21. Lee KS. We need the board of independent medical examiners in Korea. Korean J Med Law 2001; 9: 109-18.
  22. Ministry of Health & Welfare (KR). Residency training program: notification 2013-39 [Internet]. Seoul: Korea Ministry of Goverment Legislation; 2013[update 2013 Feb 28; cited 2015 Mar 1]. Available from: http://www.law.go.kr/LSW/admRulInfoP.do?admRulSeq=2000000022394.
  23. Lee KH, Yoon DM. A severe retropharyngeal hematoma after stellate ganglion block: a case report. Korean J Pain 2008; 21: 62-5. https://doi.org/10.3344/kjp.2008.21.1.62
  24. Kim YD, Lee JH, Cheong YK. Pneumocephalus in a patient with no cerebrospinal fluid leakage after lumbar epidural block-a case report-. Korean J Pain 2012; 25: 262-6. https://doi.org/10.3344/kjp.2012.25.4.262
  25. Kim TS, Shin SS, Kim JR, Kim DY. Air bubbles mimic disc herniation in MRI after cervical epidural block. Korean J Pain 2010; 23: 202-6. https://doi.org/10.3344/kjp.2010.23.3.202
  26. Swerdlow M. Medico-legal aspects of complications following pain relieving blocks. Pain 1982; 13: 321-31. https://doi.org/10.1016/0304-3959(82)90001-X

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