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

Cheol Won Hyeon,Won Lee,So Yoon Kim,Ji Yong Park,Su Hwan Shin 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

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.

난원공 개존을 통한 우심방에서 좌심방으로의 단락 진단에 있어 경흉부 심초음파 하모닉 영상의 유용성

신미승,강석민,장길진,변기현,하종원,정남식,허지회,이병인 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

바이러스 감염 후 발생한 소아에서의 시선경염 1례

신지원,김영대,김우경,박용원,오인경 인제대학교 2009 仁濟醫學 Vol.30 No.-

Optic neuritis presents differently in children than in adults. Children typically have bilateral involvement with papillitis following an antecedent viral illness. The development of multiple sclerosis is less common in children. The diagnosis of optic neuritis is usually made on a clinical manifestations. The major symptoms of optic neuritis include one or more of the following: 1) sudden blurred, "foggy" vision and sudden loss of vision, 2) pain with eye movement in the affected eye, 3) sudden color blindness, and etc. This condition progresses over a few days to two weeks. A 12-year-old girl presented with a history of sudden visual loss and color blindness. Treatment with high doses of steroid resulted in visual function returning to normal.

Analysis of acne-related judicial precedents from 1997 to 2018 in South Korea

( Ji Hoon Yang ),( Soo Ick Cho ),( Su Hwan Shin ),( Won Lee ),( So Yoon Kim ),( Dae Hun Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Medicolegal disputes are increasing in practical medicine. Acne is a common problem but is usually related to cosmetic problems such as acne scars. Medications or procedures related to acne could lead to medical malpractice. Objectives: To analyze medical litigation associated with acne or acne scar in South Korea. Methods: Acne-related judgements were searched using the Supreme Court of Korea’s Written Judgment Management System based on the keywords “acne” or “acne scar.” Results: Eleven cases were selected as litigated cases of acne or acne scar. Eight cases (72.7%) were related to acne scar and three (27.3%) were related to acne. Treatment modalities such as peeling (n = 6), laser treatment (n = 3), photodynamic therapy (n = 1), and antibiotic (n = 1) resulted in lawsuit. Claimed sequelae of the treatment were hyperpigmentation (n = 5), scar worsening (n = 5), erythema (n = 3), skin bumps (n = 1), and liver transplant (n = 1). Eight cases (72.7%) were awarded to the plaintiff, and the others were dismissed. The average awarded amount was 16,801,324± 24,452,486 (mean±standard deviation) Korean Won. Conclusion: Various treatments for acne or acne scar can cause medical disputes. Unnecessary litigation could be prevented if simple measures such as history taking, choosing proper procedure, and adequate management after the procedure along with sufficient informed consent were performed.

기술수준에 따른 여자축구 인프론트 킥 동작의 협응구조

지보경,육동원,김지수,신정택 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

The purpose of this study was to investigate coordination structure of infront kick in women soccer as a function of skill level. To succeed this purpose, four girls' high school students who had never experienced soccer before were selected as novices, and four girls' high school students who had played soccer for over three years as experts in this lab. To recognize the change of coordination structure according to practice, novices had practiced infront kick in soccer for two weeks. consequently they were taken films of kicking motion three times -before practice, after one week practice, after two weeks practice. However, experts were taken once. The experimental instruments for this study consisted of a video camera, reference frame. LED and APAS for digitizing. Angle to angle diagrams and phase plan portraits for qualitative analysis of coordination structure were gotten with LabVIEW 6i. The conclusions are as follow: firstly, novices' coordination structure had been changed since practice. Secondly, there were significantly different between coordination structures of experts and pre-practice novices. Lastly, there were similar between coordination structures of experts and post practice novices.

항 혈소판 요법을 이용한 관동맥내 Stent 삽입술의 조기 결과

손지원,김영준,손민수,오세진,안태훈,최인석,신익균 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

Combination Effects of Essential Oils from Thymus species with Norfloxacin against Streptococcus pneumoniae

Kim, Ji-Hyun,Sim, Youn,Shin, Seung-Won 덕성여자대학교 약학연구소 2005 藥學論文誌 Vol.16 No.1

The combination effects of essential oils from Thymus quinquecostatus and T. magnus with norfloxacin were evaluated against three strains of Streptococcus pneumoniae. The checkerboard titer test results demonstrated significant combined effects of norfloxacin and the two Thymus oils or thymol, the main component of this oil, against the susceptible and resistant strains of S. pneumoniae, with FICIs ranging from 0.14 to 1.00. Additionally, the anti-Streptococcus effects of the oils were dose-dependent on Tryptic soy agar plates containing 5% defibrinated sheep blood.

cis-platin에 의한 급성구토예방의 Dexamethasone의 4가지 정주량의 비교

김원,강지은,서영선,이동민,서정균,신병철,정기영,박유환,정춘해 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

B5-hydroxytryptamine _3수용체(5-HT_3) 길항제와 dexamethasone의 동시투여가 cis-platin에 의한 급성 구토를 막는데 가장 효과적이다. 그러나 현재까지 가장 적절한 정주dexamethasone의 용량이 알려져 있지 않았다. 이에 dexamethasone의 4가지 다른 용량을 투여하여 그 효과를 비교하였다. 환자는 임의 추출되어 cis-platin 투여 45분전에 15분 동안 정주로 각각 dexamethasone 5, 10, 15, 20 mg을 투여 받았다. cis-platin 투여 30분전에는 ondansetron 8 mg이 부가하여 정주 되었다. 1999년 3월부터 2000년 2월까지 54명의 환자가 연구에 등록되어졌고 53명의 환자가 연구 대상으로 실험에 4군 (dexamethasone 5 mg 13명, 10 mg 14명, 15 mg 13명, 20 mg 13명)으로 나뉘어 평가 되어졌다. 급성구토와 구역질의 완전한 예방은 dexamethasone 5 mg을 투여 받은 환자에서 각각 69.2%, 60.9%, dexamethasone 10 mg을 투여 환자에서 69.1%, 61%, dexamethasone 15 mg 투여 환자에서 78.5%, 66.9%, dexamethasone 20 mg을 투여 환자에서 83.2%, 71.0%로 나타났다. 구토로부터 완전한 예방은 dexamethasone 20 mg을 투여 환자에서 5, 10 mg을 투여 환자와 비교하여 높았고, dexamethasone 15 mg을 투여 군에 비교하여서는 약간 우수한 효과만 있었다. 구역질으로부터의 완전한 예방도 월등한 것은 아닐지라도 20 mg을 받은 환자에서 높았다. 항 구토 치료는 특별한 불편 없이 조절되었고, 부작용의 발생에서 4가지그룹간에는 커다란 차이가 발견되지 않았다. Dexamethasone의 20 mg 정주양이 cis-platin으로 인한 급성구토를 예방하는데 가장 효과적인 예방량으로 사료되어진다. Background and objective: A 5-hydroxytryptamine _3(5-HT_3) receptor antagonist plus dexamethasone is the most efficacious antiemetic prophylactic treatment for the prevention of cis-platin induced acute emesis, but the optimal intraveous (Ⅳ) dose of dexamethasone is unknown. This prompted us to perform a randomized, double-blind, dose-finding study that compared four different doses of dexamethasone. Materials and Methods: Patients were randomized to receive dexamethasone, either 5, 10, 15, 20 mg, administered by 15-minute Ⅳ infusion 45 minutes before cis-platin. Ondansetron 8 mg was added to dexamethasone and was administered Ⅳ 30 minutes before cis-platin. From March 1999 to February 2000, 54 patients were enrolled onto the study and 53 were assessable according to the intention-to-treat principle (13 patients received 5 mg; 14 patients, 10 mg; 13 patients, 15 mg and 13 patients, 20 mg of dexamethasone). Results: Complete protection from acute vomiting and nausea was achieved by 69.2% and 60.9% of patients, respectively, who received 5 mg of dexamethasone, by 69.1% and 61.0% of those who received 10 mg, by 78.5% and 66.9% of those who received 15 mg, and by 83.2% and 71.0% of those who received 20 mg of dexamethasone. Complete protection from vomiting was significantly superior in patients who received 20 mg compared with those who received 5 and 10 mg of dexamethasone (P<05) and was superior, but not significantly, compared with those who received 15mg. Complete protection from nausea was superior, but not significantly, in patients who received 20 mg of dekamethasone. Multifactorial analysis confirmed these results. Antiemetic treatment was well tolerated, and no significant difference was found among the four groups in the incidence of adverse events. Conclusion: A 20mg single Ⅳ dose of dexamethasone should be considered the most efficacious prophylactic dose for the prevention of ois-platin induced acute amesis in treatment of cancer.

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

Flavobacterium meningosepticum에 의한 균혈증 1예

장성원,유진홍,진승원,김선우,김연식,박순민,이대훈,최민호,최주연,신완식,강문원,강지민 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

1996년 6월 카톨릭대학교 부천성가병원에 뇌경색으로 입원했던 61세 남자 환자의 혈액에서 Flavobacterium meningosepticum을 분리하였다. 환자는 폐렴을 동반한 패혈증의 예로 ceftriaxone과 metronidazole을 투여하였으나 입원 48시간만에 사망하였다. Flabovacterium meningosepticum is a rae cause of nosocomial infection which shows multi-drug resistance. It mainly invades patients with impaired immunity. Recently, we experienced a case of F. meningosepticum bacteremia in a patient with chronic debilitated state owing to stroke. The clinical progress was so rapid that he died within 48 hours. Blood culture revealed F. meningosepticum which showed characteristic yellow colony in blood agar plate.