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Medicolegal Aspects of Otologic Clinical Practice
Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
What’s inside
7 sections · 78 slides
Overview
- Scope of this topic
Malpractice exposure in otology
- Lifetime litigation risk in surgical subspecialties
- Conflicting data across malpractice databases
- Distribution of legal allegations against otologists
- Frequency of legal allegations in otology malpractice cases
The legal test for negligence
- Four elements of negligence
- Which element is actually contested
- Establishing the standard of care
- Courtroom where standard of care is argued
- Definition of a clinical practice guideline
- Guidelines as evidence in court
- Gavel resting on a medical and surgical reference text
- AAO-HNS otology guidelines relevant to practice
- AAO-HNS clinical practice guidelines related to otology, with year published and updated
- AAO-HNS clinical practice guidelines related to otology, with year published and updated (continued)
- Justified deviation from a guideline
Clinical practice and consent
- The clinic as a source of liability
- Informed consent allegations
- Informed consent as a process
- Design of the consent document
- Standards for clinical documentation
- Risks of copy and paste in the electronic record
- Delay between injury and litigation
- Clinic staff and patient perception
- Timeliness of results and correspondence
- Discoverability of electronic communication
- Documenting imaging review accurately
- Patients recording clinical encounters
- Jurisdictional variation in wiretapping law
Ototoxicity and clinic procedures
- Ototoxic agents familiar to otologists
- Topical agents with a non-intact tympanic membrane
- Profile of medication-related hearing loss claims
- Monitoring patients on ototoxic medication
- Drug interactions and patient-specific risk
- Cerumen removal as a litigated procedure
- Documentation for cerumen and effusion procedures
- Otoscopic appearance of the tympanic membrane
Surgical litigation in otology
- Common alleged injuries in otologic surgery
- Alleged injuries and outcomes from otology litigation
- Surgical procedures and verdict outcomes from otology litigation
- Wrong site surgery in otology
- Verification of surgical laterality
- Limits of team-based verification
- Facial nerve injury in otologic litigation
- Operative note scrutiny in facial nerve cases
- Technical errors that are hard to defend
- Facial nerve monitoring in practice
- Hearing loss claims and preoperative audiometry
- Rehabilitation and paediatric follow-up of hearing loss
- Dizziness claims in otolaryngology
- Error patterns in non-surgical dizziness claims
- Consequences of unrecognised bilateral vestibular loss
- Managing expectations before ablative procedures
Patient factors, disclosure and testimony
- Paediatric patients in malpractice claims
- Considerations in elderly patients
- Conduct after an adverse event
- Management of injury recognised during surgery
- Staged repair and hospital disclosure policy
- Role and obligations of the expert witness
- Practical preparation for giving testimony
- Statement on qualifications and guidelines for the physician expert witness
- Statement on qualifications and guidelines for the physician expert witness (continued)
- Statement on qualifications and guidelines for the physician expert witness (continued)
- Summary of otologic malpractice patterns
- Habits that minimise litigation risk
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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