Korean J Intern Med.  2020 May;35(3):605-618. 10.3904/kjim.2018.365.

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Affiliations
  • 1Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Division of Medical Law and Bioethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Korea
  • 3Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, Korea
  • 4Yonsei University Law School, Seoul, Korea
  • 5Doctoral Program in Medical Law and Ethics, Yonsei University, Seoul, Korea
  • 6Blue Urology Clinic, Seoul, Korea

Abstract

Background/Aims
Possible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis.
Methods
A total of 13 cases (20 judgments) found in the Supreme Court of Korea’s Written Judgment Management System from 1998 to 2017 were analyzed.
Results
Coronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won.
Conclusions
Physicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

Keyword

Coronary angiography; Percutaneous coronary intervention; Malpractice; Dissent and disputes; Jurisprudence
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