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Article Dans Une Revue Anesthésie & Réanimation Année : 2020

Postoperative pulmonary embolism and medical liability

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Résumé

Objective > Our study tries to enlighten the anaesthetists about expert determination for damage in connection with a postoperative pulmonary embolism. It also seeks to help medical liability experts working in this area. Here, we focused on the difficulties to consider the damage as a non-offending medical accident in these cases. Study design > Retrospective observational and qualitative study. Methods > We analysed 14 expertises issued to opinion of Conciliation and Compensation Commissions of the Picardy and Hauts-de-France region. We excluded expertises finding fault. The collected data has been anonymised. Results > Ten expertises about postoperative pulmonary embolism without medical fault, occurred between 2003 and 2018, were studied. Half of them revealed a non-offending medical accident, three a possible evolution of the patient's medical history and two a mix of these two qualifications. Conclusions > Postoperative pulmonary embolism diagnosis is difficult. Owing to infrequent autopsies, its accountability is sometimes wrongly retained during expertise. The responsibility of the patient's prior state of health is largely undervalued. Side effects of pulmonary embolism treatment are rarely considered as part of the damage by the experts. We have proposed a decision tree to improve experts' decisions on non-offending medical accident in postoperative pulmonary embolism case.
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Dates et versions

hal-03598246 , version 1 (04-03-2022)

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Arnaud Leger, Dominique Montpellier, Cecile Manaouil. Postoperative pulmonary embolism and medical liability. Anesthésie & Réanimation, 2020, 6 (4), pp.383-395. ⟨10.1016/j.anrea.2019.11.026⟩. ⟨hal-03598246⟩
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