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LITIGATION IN GYNAECOLOGY 2012

LITIGATION IN GYNAECOLOGY 2012. Litigation. Impact of law in O&G far outweighs other medical fields Substantially more interaction with the health care system: Pregnancy Avoidance of pregnancy Childbirth Menopause. NHS: £400m paid out for malpractice

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LITIGATION IN GYNAECOLOGY 2012

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  1. LITIGATION IN GYNAECOLOGY2012

  2. Litigation • Impact of law in O&G far outweighs other medical fields • Substantially more interaction with the health care system: • Pregnancy • Avoidance of pregnancy • Childbirth • Menopause

  3. NHS: • £400m paid out for malpractice • 60-70% related to Obstetrics, but only 26% of workload • USA: • $3,5m

  4. Hippocratic Oath • "First, do not harm" BUT • Human error is inevitable • New treatments and technologies are constantly emerging

  5. GYNAECOLOGY • Fit • Young patients • Previously healthy • Elective procedures • Subfertility • Family planning / abortion • Menstrual disorders

  6. REASONS FOR LITIGATION • Failure to explain risks and success rates • Changing the proposed treatment • Complications • Delayed / mistaken diagnosis • Practicing beyond one’s experience • Performing a procedure without indication

  7. Decision to sue • Predisposing factors: • Poor communication • Rude • Precipitating factors: • Complications • Failure to provide adequate care

  8. When things go wrong • Be open with the patient: • Explain truthfully • Do not be evasive • Answer all questions • Offer support

  9. Reducing numbers of incidents • Valid consent • Guidelines aren't meant to dictate clinical practice • Particular care must be taken with new procedures for which the benefits and risks are uncertain • Use of drugs for unlicensed indications

  10. ABORTION • Failed termination of pregnancy Ongoing pregnancy • Retained products of conception • Perforation and trauma to other structures

  11. STERILIZATION SOCIAL OPERATION • Defective consent • Failed sterilization Pregnant at time of procedure Recanalization of fallopian tubes

  12. OTHER PROCEDURES • ECTOPIC PREGNANCY • Delayed or wrong diagnosis • LAPAROSCOPY • Injury to other organs Laparotomy

  13. OTHER PROCEDURES • HYSTERECTOMY • No indication • Oophorectomy • Damage to other structures “The venial sin is injury to the ureter, but the mortal sin is failure of recognition”

  14. OTHER PROCEDURES • UROGYNAECOLOGY • No perfect operation for incontinence

  15. CONCLUSION • Be aware of risks, benefits and complications • Know the civil and criminal laws relating to Obs and Gynae Informed consent

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