• The Journal of the Korean dental association
• /
• v.53 no.2
• /
• pp.82-95
• /
• 2015

Background: Interest in medical malpractice claims and accidents is a day-to-day social issue to general public as well as medical personnel. Related laws and regulations already have been established, and institutions based on the laws and regulations also have been founded. However, in our dental community, interest and response to the issue seem insufficient. Methods: We searched four medical literature databases that are mainly cited in the medical community. Keywords including 'dental malpractice claims', 'patient safety' and 'medical accident' were used for the search. Among the selected literatures, we chose specific ones separately whose content is authentic and easily approachable. Results: Medical malpractice claims and accidents tend to increase around the world. As the cost or the difficulty level of surgery increases, the dispute rate also increases, which appears even more apparent in developed countries. Preventive measures to prevent the disputes and accidents are not significantly different. Three critical of them include relationship of doctor with patient, the informed consent and medical record. Conclusion: Tools for accident occurrence or communication improvement have been introduced. All of those cost time and money. However, education or professional request of liability insurance companies, self-education and provision of guidelines can be immediately implemented. To implement those, dentists' promotion at the regional or national level is imperative. rhBMP-2 is widely used at sinus augmentation, alveolar bone defect, and socket preservation.

• The Korean Society of Law and Medicine
• /
• v.15 no.1
• /
• pp.211-237
• /
• 2014

Because of unpredictability and high possibility of abnormal results by clinical trials compared to general medical behaviors, a procedure for ensuring with sufficient explanations by investigators must be secured. Therefore, in a sequence of clinical trials, what kinds of scope, stage, and method of explanations provided by investigators, including doctors or researchers, to trial subjects are closely related to the compensation for damages by violation of liability for explanation. In case of application of clinical trials to patients who have critical illness such as cancer, issues of "Quality of Life" regarding trial subjects, cancer patients, should be discussed. Especially, in case of clinical trials for terminal cancer patients, the right of subjects' self-determination, which is a fundamental principle in medical behaviors, should be discussed. The right of self-determination includes participation in clinical trials for the possibility of life-sustaining even a little bit, or no participation in clinical trials in order to have a time for completing the rest of his life. Like this, if the extent and scope of explanations related to the issues of "Quality of Life" are raised as main issues, the evaluation of "Quality of Life", should be a prerequisite. In many occasions, realistically, despite bad results such as deaths or serious adverse drug reactions after clinical trials, it may not be easy for compensating to trial subjects or their survivors, who requested civil compensation for damage. Futhermore, in abnormal results after concealment of clinical trials or performance of clinical trials without permission, and in the case of trial subjects' failures of proving proximate cause between the clinical trials and abnormal results, problematic results such as no protection to the trial subjects could be occurred. In performing clinical trials, investigators should provide sufficient explanations for trial subjects and secure voluntary informed consents from the trial subjects. Therefore, clinical trials without trial subjects' permissions and the informed consent process violate trial subjects' rights of self-determination, and the investigators shall be liable for compensation for damages. Then, issues might be addressed are what are essential contents of patients' "rights of self-determination" infringed by clinical trials without subjects' permissions. Two perspectives about patients' rights of self-determination might be considered. One perspective regards physical distress of patients (subjects) from therapies without sufficient explanations as the crux of the matter. The other perspective regards infringement of human dignity caused by being subjects without permission as the crux of the matter irrespective of risks' big and small influences. This research follows perspective of the latter. Forming constant fiduciary relation between investigators (doctors) and subjects (patients) pursuant medical contracts, and in accordance with this fiduciary relation, subjects, who are patients, have expectations of explanations and treatments by the best ways. If doctors and patients set this forth as a premise, doctors should assume civil liability when doctors infringe patients' expectations.

• Korea Journal of Hospital Management
• /
• v.6 no.1
• /
• pp.1-17
• /
• 2001

According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

• Molecules and Cells
• /
• v.23 no.1
• /
• pp.39-48
• /
• 2007

Charcot-Marie-Tooth (CMT) disease and hereditary neuropathy with liability to pressure palsies (HNPP) are frequent forms of genetically heterogeneous peripheral neuropathies. Reciprocal unequal crossover between flanking CMT1A-REPs on chromosome 17p11.2-p12 is a major cause of CMT type 1A (CMT1A) and HNPP. The importance of a sensitive and rapid method for identifying the CMT1A duplication and HNPP deletion is being emphasized. In the present study, we established a molecular diagnostic method for the CMT1A duplication and HNPP deletion based on hexaplex PCR of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S918, D17S4A and D17S2230). The method is highly time-, cost- and sample-saving because the six markers are amplified by a single PCR reaction and resolved with a single capillary in 3 h. Several statistical and forensic estimates indicated that most of these markers are likely to be useful for diagnosing the peripheral neuropathies. Reproducibility, as determined by concordance between independent tests, was estimated to be 100%. The likelihood that genotypes of all six markers are homozygous in randomly selected individuals was calculated to be $1.6{\times}10^{-4}$, which indicates that the statistical error rate for this diagnosis of HNPP deletion is only 0.016%.

• The Journal of Korean Medicine
• /
• v.41 no.1
• /
• pp.1-10
• /
• 2020

Objectives: This study investigated the financial performance of Korean Medicine hospitals in Korea in order to understand the current status of hospital management and improve its efficiency. Methods: Financial statements of 24 medical corporations, 19 juridical foundations and 18 school hospitals from 2016 to 2018 were obtained from the secondary data published by the Health Insurance Review and Assessment Service, the National Tax Service and the Korea Advancing Schools Foundation. Financial performance was measured on 6 dimensions: liquidity, profitability, activity, growth, cost and productivity (investment efficiency) by analyzing 8 financial indicators: Liability to Total Assets, Net Profit to Patient Service Revenues, Total Assets Turnover, Growth Rate of Patient Service Revenues, Operating Expenses to Patient Service Revenues, Value Added to Patient Service Revenues, Value Added to Total Assets, and Value Added to Personnel Expenses. Results: Korean Medicine hospitals showed lower Liability to Total Assets, Liquidity and Value Added to Total Assets than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than those of Western Medicine hospitals do. The net profit decreased significantly (-50.8%) in 2018 whereas Patient Service Revenues increased (6.9%) for the same period due to Operating Expenses increase and Non-Operating loss. Conclusions: These findings suggest that the Korean Medicine hospital sector in Korea needs to improve liquidity and financial structure and to enhance profitability by reducing Personnel Expenses and generating Non-operating revenues in order to improve its investment efficiency and competitiveness.

• The Korean Society of Law and Medicine
• /
• v.24 no.2
• /
• pp.147-196
• /
• 2023

Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.

• The Korean Journal of Air & Space Law and Policy
• /
• v.29 no.2
• /
• pp.55-86
• /
• 2014

The U.S. General Aviation Revitalization Act of 1994 (the "GARA") created a statute of repose that bars any claims arising from an aviation product or component more than 18 years after its date of delivery. The statute was enacted to protect general aviation aircraft manufacturers from the excessive product liability costs. The GARA included four exceptions: (a) medical emergency patients, (b) those not on the aircraft, (c) those based on written warranties, and (d) those causally related to a "knowing misrepresentation" made by the manufacturer to the FAA. The GARA also incorporates a provision for revised starting point of reckoning to which any repairs or replacements of an aviation product. This note aimed to discuss General Aviation and GARA in depth including the meaning of statue of repose, its exceptions. The various precedents about GARA were also reviewed in here as well. From the GARA, as a comparative legal issue in aviation product liability, there can be some suggestions for revision of Korean Products Liability Act. First, it seems to be reasonable to regulate the specific statute of repose provisions for various category of products. In GARA, the period of 18 years is reasonable concerning to the average aircraft life. Second, in order to avoid exhausting debate and for the judicial economy, it needs to clarify when the statute begins to run. GARA's 18 year limitation period begins to run on the different date whether it was delivered to its first purchaser or a person engaged in the business of selling the aircraft. Last but not least, proper exceptions should be added into the law for equity matter of the statute of repose does not apply. For example, a manufacturer is not protected by GARA if it knowingly misrepresents certain safety information to the FAA.

• The Korean Society of Law and Medicine
• /
• v.16 no.1
• /
• pp.3-82
• /
• 2015

This paper is concerned in the theme of the liability for the breach of duty to inform(Haftungszurechnung der $Aufkl{\ddot{a}}rungspflichtverletzung$) and the malpractice of cosmetic surgery. Here, the terms, treatments for healing purposes and purely medical-technical cosmetic operations are well integrated in the category of "medical conduct(medizinische Handlung)" within the meaning of the public and administrative 'Medical Law'. In the judgment of 6. 13. 2013 Az. 2012DA94865 provides the KHGH(Korean Highest Court of Justice) to inform the patient about the prospects and risks of cosmetic surgery(Infrabrow Excision Blepharoplasty) stringent requirements, similar to the judicature of BGH(cf. BGH, Urt. v. 6. 11. 1990, Az.: VI ZR 8/90). Even in the judgment of 5. 12. 2014 Az. 2013GASO865646 the SZLG(Seoul Central Regional Court) recognizes the physician contract for 'cosmetic septoplasty' as a sort of contract for work. The medical treatment(${\ddot{a}}rztliche$ Heilbehandlung) is still regarded as a prototype of the medical activity, therefore in the meaning of the 'Civil Law(KBGB)', its term needs to be used immediately for healing purposes. The cosmetic operation, desired by a patient, differs from the healing treatment by the element of "indication" and the fact that the "healing purpose(Heilzweck)" itself is missing. In comparative context - methodically fully aware that the unreflective term transfer between different laws might contradict their legal purposes - a series of judgments BSG(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.) and some judgments of LSG are reviewed. In addition, also the dogmatic topic for the "legal natur of a medical treatment contract" is to reconsider by comparative introducing BGHZ 63, 306. Now in view of the current state of greater popularity of artificial cosmetic surgery still indeed is the sentences: The doctor is minister naturae, a helper of nature. A doctor promises regularly only the proper treatment of the patient, but the contractual liability for work should not be excluded in medical conditions for cosmetic surgeries altogether. "With cosmetic operations, seeking to eliminate the external deformities, the doctor may miss the medical profession entirely." - A. Laufs, Medical Law, 5th ed. P. 18.

• The Korean Society of Law and Medicine
• /
• v.24 no.1
• /
• pp.43-65
• /
• 2023

The healthcare industry is a digital healthcare that combines technology based on the 4th Industrial Revolution, dealing with information on individual health and medical care, and is a fusion of health care services and medical science and technology. It is questionable whether digital healthcare according to the paradigm change can be discussed by the concept of medical practice under the existing Medical Act. There is no clear definition of the concept of medical practice in the Medical Service Act, but the concept is established through precedents. In addition, under the Medical Service Act, the subject of medical practice is limited to medical personnel. However, digital healthcare sometimes diagnoses and treats diseases using digital technology by medical personnel. On the other hand, what is possible by non-medical personnel is digital healthcare. This is because digital healthcare is understood as a concept that includes health care such as exercise, eating habits, and weight control. For this reason, if the concept of medical practice under the "Medical Act" on digital healthcare is included, it is subject to criminal punishment for "unlicensed medical practice" prescribed in Article 27 of the "Medical Act". In the health and medical industry, digital transformation and convergence with information and communication technology are rapidly progressing. As a result, there is a need to newly define it as 'digitalized medical practice' or 'information and communication technology (ICT)-based medical practice' separately from existing medical practices. The concept of medical practice has variability, not a fixed and invariable concept. However, in response to this demand, it is not an infinite expansion of the concept of medical practice, but a request to reset its scope. Therefore, the concept of medical practice should be legislated by reflecting the demand of consumers for the medical service system.

• The Korean Society of Law and Medicine
• /
• v.20 no.1
• /
• pp.83-107
• /
• 2019

In order to resolve a dispute over a medical accident, the court is in the process of appraising the medical records for medical professionals to report their medical expertise or judgments using that knowledge. The consequences of expert opinion about a medical accident are only one of the methods of evidence as a reference. Therefore, in principle, the court should not be bound to the results, but the court, which is not a medical expert, can not completely rule out medical expert opinion as to whether there is medical malpractice and causality. Therefore, it can not be denied that the proportion of expert opinion of medical records in the dispute about medical accidents is high and it has an important influence on the judgement of the court. In this paper, we examine the significance and function of expert opinion of the medical accident, examine the appraising procedure of the medical records in the court and the appraising procedure of the medical accidents of the Korean medical dispute mediation arbitrator do. In addition, I would like to examine what kind of attitude is being taken in response to expert opinion of medical records in Korea to court, to examine the implications of the case of Japan as a foreign system, and to suggest improvement points in the expert opinion procedure of medical record filing in Korea. In particular, I would like to suggest improvements on issues such as the fairness of the expert opinion of medical records and the delays in litigation due to delays in the process of expert opinion.