The purpose of this study was to describe closed medical-legal cases with physicians and spine surgery in Canada from a trends and patient safety perspective. Its evaluations are always based on current evidence-based treatment recommendations, taking into account the values of multidisciplinary approaches and the availability of minimally invasive and movement-preserving surgical techniques. The meticulous collection of history and the great attention to detail of clinical presentation and examinations set it apart from most other medico-legal service providers. Medico-legal opinions are provided to courts, tribunals and hearings when independent medical advice is required. Its purpose is to ensure that an accurate medical diagnosis is made, which will provide treatment options to return the claimant to the pre-accident state. As soon as a stable condition has been medically reached, a disability assessment can be performed if necessary. For more information on its clinical negligence and personal injury reporting costs and full terms and conditions, please contact Rachel Read directly on 07833 475406 and firstname.lastname@example.org Andrew Quaile FRCS has been providing Medico legal services since 1990 and currently issues over 300 written medico-legal reports each year. Today, Andrew`s experience and expertise is commonly used by plaintiffs and defendants, sometimes as the sole joint expert. The goal of Spineworks` forensic reports is to provide the most effective way to improve quality of life after injury.
1. Provided that Dr. Aliashkevich thoroughly reviews legal documents and analyzes background information. Any possible inconsistencies are identified to be checked before the customer is seen. Therefore, it is important to have the documents at least three days in advance so that we have time to read them.2. All available radiology providers are checked for relevant examinations and examination/reference data are noted. Relevant images were viewed and selected for presentation in the final report.3. Customers are asked to fill out the forms with details and dates of their violations.
When clients have difficulty writing/understanding questions, they are assisted by assistants. We strive to send the forms to clients in a timely manner so that they can prepare them at will and understand what questions will be asked during the appointment. The completed forms are checked by Dr. Aliashkevich and compared to check their consistency with the medical history obtained in steps 1 and 2. 4. Customer history is saved in a personal conversation and missing details or discrepancies from steps 1 to 3 are clarified. The history is summarized in the presence of the customer so that he can make changes directly. Handwritten notes are collected and stored in a file for future reference.5. When customers leave, their history is checked again to check for consistency with available records, analytics, and survey results. If important information is missing or needs to be reviewed, we receive clarifications and updates before sending the final report to lawyers or insurers.
Objective: To characterize the current forensic environment of spinal surgery by analyzing a current data set on malpractice processes. Forensic reports provide much more detail than the usual specialist letters. These are legal documents that can be used as evidence in court. In some complex cases, reports can be 30 to 50 pages long. In some situations, literature review and additional evidence (e.g., video footage, surveillance footage) may be required. Naturally, it can take several weeks to analyze all the evidence and produce a full report that can be presented to a judge and jury. A systematic and thorough analysis of forensic cases can provide rich contextual information about the factors that help support prevention efforts. The Canadian Medical Protective Association (CMPA) – a national, not-for-profit mutual defence organization that provides physicians with legal medical assistance, including civil litigation and complaints to medical regulatory authorities (colleges) – is uniquely positioned for these analyses. Unlike pure case law analyses, the wide range of topics addressed in these questions allows for comprehensive analyses. The knowledge gained can inform patients and help medical educators, institutions and surgeons identify new opportunities to increase patient safety.
As patient safety events decrease, so do the number of complaints.17 The authors thank Syeda Faisal, Jun Ji, and Richard Liu for their analytical support; Sara Khangura for reviewing the study protocol and draft manuscripts; Marie Primeau-Maurice for the production of the figures; Donna Zuccala for the description of intervention codes for spine surgery; and Ria De Gorter for her assistance with the manuscript submission process. The authors also thank the CMPA`s Medical Care Analysis Service data entry team for the forensic coding. A combination of strategies could improve patient safety. First, our findings support medical training of spine surgeons on clinical decision-making. Second, institutions could consider promoting interprofessional communication through team training to help surgeons make decisions. Third, we urge surgical managers to reassess and optimize their local systems to prevent spine surgery in the wrong place. To achieve this goal, the surgical safety checklist36 could be adapted to take into account patient-specific risk factors for poor level spine surgery and preparation for site identification. As the safety of spine surgery improves, we expect the medico-legal risks for spine surgeons to increase as well. Key Points A retrospective descriptive study was conducted to understand closed medico-legal cases of spine surgery in Canada. Although the number of spinal surgery cases decreased over time, the damage to patients in the majority of recently closed cases was due to health care.
Recently closed cases involved intraoperative injuries, misdiagnosis, and surgery in the wrong place. There are still critical opportunities to increase patient safety in spine surgery. The 15-year trend analysis focused on annual medico-legal case rates, that is, the number of medico-legal cases of spine surgery per year of CMPA membership for neurosurgeons and self-identified orthopedic surgeons, multiplied by 1000. We adjust a linear trend to these rates and calculate the annualized rate of change based on that trend. We then determined the statistical significance of this rate of change over time and relative to two reference populations (rates for CMPA members in a surgical specialty [CMPA-defined] or all CMPA members) using the sum of squares tests of ANOVA type III and SAS software. version 9.4; P-values <0.05 indicated statistical significance. For contributory factor analysis, we calculated descriptive statistics using an internal data analysis tool and Microsoft Excel. For privacy reasons, only the most common features (top 3) and frequencies ≥10 are displayed.
We also conducted a subgroup analysis of the wrong location transactions. Dr. Corenman has been involved in spinal disorders for over 40 years, first as a qualified chiropractor, then as a practicing orthopedic spine surgeon at the University of Colorado, and then for 25 years at the Steadman Clinic in Vail, Colorado. He was chief of spinal trauma at Denver Health for several years.