COVID-19 MEDICO-LEGAL AND MALPRACTICE PROBLEMS: IMPLICATIONS FOR SURGEONS

B. Mastalier, A. M. Lazar, B. Ghiţă, M. Petruţescu, C. Botezatu,

Abstract: The COVID-19 pandemic has already raised medico-legal issues and could trigger an unexpected waive of malpractice claims for many years in future. In a desperate effort to limit SARS-CoV-2 transmission and to relocate the healthcare resources towards the COVID-19 management, the screening and diagnostic procedures, as well as the elective surgical treatments have been postponed or even canceled for an undetermined period of time. Therefore, only the emergency cases were surgically treated. Such decisions resulted in the presentation of the patients with more severe and complicated forms of disease, associating increased morbidity and mortality rates. A complex issue was whether a patient died of COVID-19, or the viral infection was only additional to another cause of fatality; also, whether the COVID-19 was acquired in the hospital or not. At the same time, there were debates on the ideal therapeutic management of the COVID-19 cases, as well as the best time window for the surgical intervention in such cases. Another problem, potentially fueling future malpractice claims was in the surgeons’ relocation towards treating non-surgical COVID-19 cases, for which they had neither a previous specialization, nor experience. In some states, there was a change in the legal frame in order to protect the healthcare personnel, including surgeons in such cases. However, in the states where no such decisions were taken, the surgeons are at future risk of being unjustly accused by the patients or their relatives for many years from now on.
Keywords: COVID-19 pandemic, general surgery, malpractice, protective legal frame, hospital-acquired infection, delayed treatment, emergency surgery, elective surgery.