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Legal Medicine – A local Approach. Dr Raed Hashem Emergentologist & Traumatologist. Basket. Patient Bill of Rights Standard of Care Institutional complaints vs. Judicial litigation Informed Consent When mistakes/complications happen Incident Report The Kuwaiti judicial system
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Legal Medicine – A local Approach Dr RaedHashem Emergentologist & Traumatologist
Basket • Patient Bill of Rights • Standard of Care • Institutional complaints vs. Judicial litigation • Informed Consent • When mistakes/complications happen • Incident Report • The Kuwaiti judicial system • Statute of limitation
Basket • LAMA • Refusal of treatment • Chaperone • Senior & junior duties and responsibilities • MRP & transfer of care • Doctor-patient altercation • Doctor-patient personal relationship • Airplane Emergencies
Today • 1) An introduction to Legal Medicine • 2) Elements of negligence
Where are we today? • Legal Medicine & Medical Ethics • Legal Medicine teaching (doctor law degree) • US medical schools curriculum in Medical Ethics and Legal Medicine -> Mandatory 15-18 hours/year PLUS elective courses • Legal Medicine & Medical Ethics in law schools.
Components of Legal Medicine • Medical ethics • Public health • Professionalism • Philosophy • Competence • Medical humanities • Medical malpractice • End of life • Treatment of special patients
Statistics in the US • 44,000-98,000 die annually from medical negligence • OBGYN 19% • Gen Surgery 17% • Primary Care 16% (NEJM – 2006)
Statistics • 93% of malpractice cases settled prior to court hearing • 7% make it to a court verdict (US Bureau of Justice Statistics) • 21% of verdicts plaintiff prevailed in court (NEJM - 2006)
Statistics • Only 14% are reported by hospitals (US Department of Health and Human Services - 2012) • In-patients: Surgery errors 34% • Out-patient: Diagnostic errors 46% (JAMA 2009)
Cost • $35 Billions in 2009 (Congressional Budget Office Report – 2009) • 2% of total healthcare expenditures
Definition • Medical Negligence: Legal cause of action involving the failure to exercise due care expected of a reasonable heath care provider under the same or similar circumstances, of like qualifications.
Standard of Care • What is a Standard of Care”? • Standard of Care vs. “Common” Practice
Medical Negligence • Duty • Breach • Causation • Damages
Institutional complaint vs. Judicial litigation • Who is complaining? • Where is he complaining?
The Kuwaiti judicial system • How is the the Kuwaiti judicial system different than the legal system in other parts of the world?
Legal Medicine – A local Approach Dr Raed Hashem Emergentologist & Traumatologist – Amiri Hospital