<- Home <- Arhive <- Vol. 29, Issue 3, September 2021



Rom J Leg Med29(3)309-316(2021)
DOI:10.4323/rjlm.2021.309
© Romanian Society of Legal Medicine


MEDICO-LEGAL ISSUES IN DELAYED APPENDECTOMY FOR ACUTE APPENDICITIS AND RISK MANAGEMENT STRATEGIES

D. Serban, D. C. Badiu, D. V. Davitoiu, D. O. Costea, C. Tanasescu, G. A. Gangura, M. S. Tudosie, A. M. Dascalu, R. V. Scaunasu, C. Tudor


Abstract: Acute appendicitis is a major healthcare problem, being one of the most frequent emergency abdominal condition, and one of the leading causes of malpractice claims. Currently, the diagnosis of acute appendicitis relies on clinical examination, and there is no paraclinical test to confirm or infirm the diagnosis. 30% of patients with proven appendicitis are misdiagnosed and discharged by a physician before the correct diagnosis is made.
The paper is a comprehensive review regarding the cases of successful litigation in cases of delayed diagnosis of acute appendicitis and to analyze the current practical guidelines and general approach to cases with abdominal pain possible due to acute appendicitis versus the patients’ expectations regarding the standard of care, resulting in possible legal claims.
The leading cause of successfull malpractice claims related to acute appendicitis is the delay of failure to diagnose acute appendicitis before perforation occurred, accounting for 65-90% in various studies. This may cause harm to the patients by increased rate of intraabdominal and surgical site infection, prolonged pain and hospitalization, but also death. Careful patient examination, the judicious use of scoring systems based on clinical and paraclinical data and in cases with intermediate risk, of imaging tests are useful to minimize the diagnostic errors.
Understanding the causes of malpractice ligation in acute appendicitis resolved successfully in favor of the plaintiff is important to understand how these faults can be avoided in the future.

Keywords: acute appendicitis, malpractice claims, delayed diagnosis, morbidity, litigation



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