Table 3 Medical issues in CABG malpractice claims by procedure group (Created by the authors)
From: A 9-year analysis of medical malpractice litigations in coronary artery bypass grafting in China
Medical procedure | No.(%) | Associated medical malpractice |
|---|---|---|
Postoperative management | 78 (71.6%) | Failure to supervise or monitor a case Failure to recognize or misdiagnose complications No or delayed consultation Missed or false clinical examination Delay in treatment Performed when not indicated or contraindicated Medication or enteral nutrition errors Improper nursing care Premature discharged |
Preoperative management | 44 (40.4%) | Inadequate assessment Missed or false clinical examination: vascular status of lower extremities, pulmonary function, renal function, coagulopathy, hypertension, cardiac function misdiagnosed comorbidities: hypertrophic cardiomyopathy, arteriosclerosis obliterans of lower extremities, lung space occupying Improper operation scheme: Non indication surgery, improper timing of surgery, wrong surgical procedure, inappropriate selection of bridge blood vessels, too many items for one surgery, combined with other non-essential surgery, missing lesions Uncontrolled operative contraindications, Medication Errors: use of contraindicated medications, Inadequate duration of anticoagulation discontinuation Implant specification error |
Surgical procedure | 34 (31.2%) | Improper surgical procedures: bleeding, anastomotic leak, poor sternal fixation, visceral injury, bridging vessel stenosis Surgical foreign body left in patient after procedure Improper anesthesia monitoring: Intraoperative hypotension, difficulties with anesthesia resuscitation Medication Errors: Inadequate neutralization of anticoagulants |
Informed consent | 14 (12.8%) | Inadequate informed consent: Surgical complications, surgical procedure, autopsy matters, alternative treatment options, precautions for medication(anticoagulant), follow-up examinations |
Documentation writing | 5 (4.6%) | Tampering medical records, irregular modification of medical records, omission of medical records, in vivo implant information not entered medical records, not signed informed consent for treatment |
Blood transfusions | 2 (1.8%) | Bloodborne infectious diseases |