• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.57-81
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• 2016

It can determine the outcome of the lawsuit whether or not there is a causality between the medical malpractice of a physician and the patient's injury when the patient is filing a lawsuit against the physician in order to pursue civil liability for a medical accident. In medical malpractice lawsuits, it is not easy to judge causality between different civil cases because of the special nature of medical care. Also, information such as medical records is concentrated on doctors and the medical knowledge of the patient is relatively insufficient compared with the doctor. Therefore, it is recognized through medical malpractice lawsuits that the burden of proof of the causality burdened by the plaintiff patient is relaxed. In this paper, I examine the legal theory on how to recognize causality in medical civil liability and then concern the attitude of the case in Korea, which is divided into the types of the causality - such as the case of general medical practice, explanation duty, no causality with medical malpractice.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of the Korean Society of Radiology
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• v.1 no.2
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• pp.13-22
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• 2007

The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.107-135
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• 2007

In preparation of the medical examination records, the failure to correctly write the taken medical behaviors on the medical examination records, is subject to criminal conviction due to the breach of the Article 21-1. The false or overstated writings on the medical examination records is subject to the same punishment due to the Article 21-1, which $\underline{additionally}$ may lead to the administrative measures such as the suspension of license according to Article 53-1. The interpretation is considered as proper in light of the function of the medical examination records, hazard to the patients, and the doctors' ethics. In light of the attitude of The Supreme Court for the preparation obligation of the medical examination records specified in the medical law Article 21-1(Purport : The doctors may continue to use their opinions on the patient's status and treatment process on the medical examination records, may provide the proper information to other medical staff, and ought to specify the details enough to decide the appropriateness of such medical behaviors after the recent treatment.), the false writings of the doctors on the medical examination records of the non-treated patient as faithfully treated one during the entire period before the present hospitalization, will be regarded as the fulfillment obligation of the preparation of the medical examination records in the medical law Article 21-1.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.49-79
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• 2021

Due to defendant's wrongful act by implant surgery, plaintiff has been suffered serious damages to his face and teeth, and pain caused by establishing implanted teeth. Jeonju Appellate Court sentenced to pay future medical expenses and alimony to the plaintiff in compensation for breach of duty or torts. The ruling is designed to relieve the burden of proof because it is extremely difficult for non-experts to determine whether dentists violated their 'duty of care' or whether there was a causal relationship between damages to medial treatment. It was judged that if symptoms that contributed to the patient's significant outcome occurred during or after surgery, such symptoms could be presumed to have been caused by medical negligence if indirect facts were proven to be other than medical negligence. Originally, the shifting of burden of proof in Germany, has already been developed in medical malpractice case since 1940s. In order to guarantee the patients' right, §630h German Civil Code (BGB) - presumption of negligence in the realization of controllable risk- has been also legislated. BGH (Bundesgerichtshof) has been interested in ensuring that the principle of equality between patients and doctors. So, in this study, we wanted to refer to German precedent cases to analyzing Korean medical malpractice lawsuit. In particular, the decision could be significant in that it approaches closer to allows the shifting burden of proof in drastically growing dental malpractice cases. This is clearly confirmed in the judgment of the dentist's "fault" that "if indirect facts about the symptom or occurrence are proven to be cause other than medical negligence, such symptoms can be presumed to be due to medical negligence."

• Journal of radiological science and technology
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• v.28 no.4
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• pp.317-325
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• 2005

The recent medical treatment guidelines and the development of information technology make hospitals reduce the expense in surrounding environment and it requires improving the quality of medical treatment of the hospital. That is, with the new guidelines and technology, hospital business escapes simple fee calculation and insurance claim center. Moreover, MIS(Medical Information System), PACS(Picture Archiving and Communications System), OCS(Order Communicating System), EMR(Electronic Medical Record), DSS(Decision Support System) are also developing. Medical Information System is evolved toward integration of medical IT and situation si changing with increasing high speed in the ICT convergence. These changes and development of ubiquitous environment require fundamental change of medical information system. Mobile medical information system refers to construct wireless system of hospital which has constructed in existing environment. Through RFID development in existing system, anyone can log on easily to Internet whenever and wherever. RFID is one of the technologies for Automatic Identification and Data Capture(AIDC). It is the core technology to implement Automatic processing system. This paper provides a comprehensive basic review of RFID model in Korea and suggests the evolution direction for further advanced RFID application services. In addition, designed and implemented DB server's agent program and Client program of Mobile application that recognized RFID tag and patient data in the ubiquitous environments. This system implemented medical information system that performed patient data based EMR, HIS, PACS DB environments, and so reduced delay time of requisition, medical treatment, lab.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.27-53
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• 2015

Recently, a plastic surgery hospital in Seoul, has been raided following suspicions that ghost surgery was performed by an unauthorized substitute surgeon on a chinese woman who lapsed into a death. Following the incident, an organization to eradicate ghost surgery was created in March by Consumers Korea, founded to protect consumer rights, and the Korea Alliance of Patients Organization. The organization has received reports of illegal medical practices. To substitute another physician without the patient's consent and without his knowledge of the substitution is fraud and deceit and a violation of a basic ethical concept. The patient as a human being is entitled to choose his own physician and he should be permitted to acquiesce in or refuse to accept the substitution. It should be noted that it is the operating surgeon to whom the patient grants his consent to perform the operation. The patient is entitled to the services of the particular surgeon with whom he contracts. The surgeon, in accepting the patient, obligates himself to utilize his personal talents in the performance of the operation to the extent required by the agreement creating the physician-patient relationship. He cannot properly delegate to another the duties which the patient authorizes him to perform personally. 'Ghost surgery' comes under Article 257(Inflicting Bodily Injury on Other or on Lineal Ascendant) of the Criminal Code. Substitution another physician without the patient's consent and without his knowledge of the substitution shall be performed Inflicting Bodily Injury. This is a controversial issue that'ghost surgery' comes under Article 347(Fraud) of the Criminal Code. It maybe controversial that operation substituted by another physician without the patient's consent and without his knowledge of the substitution becomes the component of Fraud. Also, Ghost surgery' comes under Article 27 (Prohibition of Unlicensed Medical Practice, etc.), Article 22 (Medical Records, etc.), Article 33 (Establishment) of the Medical Service Act. The surgeon's obligation to the patient requires him to perform the surgical operation: (1) within the scope of authority granted him by the consent to the operation; (2) in accordance with the terms of the contractual relationship; (3) with complete disclosure of all facts relevant to the need and the performance of the operation; and (4) to utilize his best skill in performing the operation.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.134-144
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• 2014

The aim of this study was to investigate changes in treatment patterns within pediatric dentistry departments by analyzing the distribution of patients and treatment trends. To that end, treatment charts based on electronic medical records (EMR) from the Yonsei University Dental Hospital from 2008 to 2012 were collected and analyzed. The results showed a decrease in the number of new patients and patients cared for by non-specialists, while the number of foreign patients has increased. The under 2 years-old group accounted for a large portion of new patients. Dental caries, dental trauma, and malocclusion ranked as the top complaints. In terms of restoration treatment, the proportion of patients receiving composite resin, amalgam, and sealant has decreased, whereas self-curing glass ionomer and preventive resin restoration have increased. Single-visit endodontic treatment has been increasing, with a decreasing trend in multi-visit endodontic treatment. The rate of conservative pulp treatment, such as pulp capping and pulpotomy, has increased. For reducing patient anxiety, treatments under sedation have increased, especially with the use of nitric oxide. This investigation into the latest treatment trends and patient characteristics is expected to help pediatric dentists to make appropriate treatment plans.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.1-22
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• 1999

As people are more concerned about their health and medical care, there have been an increasing number of medical disputes due to increased medical demand. In order to prevent and provide solution to currently surging medical accidents and disputes related to orthodontic treatment, in July 1998, the Korean Association Of Orthdontists surveyed 2,200 members of Korean Association of orthodontists on 30 items to recognize the pattern of medical accidents and prevent them. The survey was about accident-related items including personal profiles of members and patients who have undergone medical accidents or disputes, the cause and solution to the accidents, cautions related to members orthodontic treatment, and medical recording and archival. Based on the survey result, we analyzed characteristics of medical accidents and disputes in orthodontic area. It is more important to predict and prevent possible medical accidents or disputes based on current situation than to solve them after disputes occur. For this, we should not be negligent in raising treatment proficiency level based on patient-doctor trust and in obtaining new medical information. We should also provide medical environment where Patients themselves can decide whether to get treatment after they are offered detailed explanation on diagnosis, treatment procedure, complication, and possible hazard. We should take caution when treating patients and pay attention to charting and maintenance, which is the most fundamental, as well. Also at the Korean Association of orthodontists level, it is desired to provide education program on prevention and solution to medical accidents and disputes, and actions and organizations that can help when accidents and disputes occur.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.