• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.3-40
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• 2018

Conventionally, there were few cases in which a medical accident became a criminal case in Japan. However, after the serious malpractice such as the Yokohama City University Hospital case, prosecutors came to be less hesitant to prosecute a malpractice. In a medical accident, the attribution of the responsibilities among medical personnel becomes one important element of the proof of negligence. The Supreme Court concluded that, when the attribution of the responsibilities is not established among medical personnel to confirm the identity of the patient like the Yokohama City University Hospital case, all the personnel who were involved bear the responsibilities to identify the patient. For serious cases which requireut most carefulness fortreatment such as the Saitama Medical University Hospital case, not only the chief physician in charge of the case concerned but also the director of the branch at the university hospital bear the responsibilities to confirm the treatment policy of the case. After the acquittal of the Ohno Hospital case, the voice demanding more prudent prosecution of malpractices has become stronger than before. Meanwhile, Ministry of Health, Labour and Welfare introduced Medical Accidents Investigation System for the prevention of medical accident and, has reinforced the third party inspection of medical accidents.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.163-199
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• 2005

Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

• Safety and Health at Work
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• v.4 no.3
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• pp.160-165
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• 2013

Background: Occupational accidents are unplanned events that cause damage. The socio-economic impacts and human costs of accidents are tremendous around the world. Many fatalities happen every year in workplaces such as electricity distribution companies. Some electrical injuries are electrocution, electric shock, and burns. This study was conducted in an electricity distribution company (with rotational 12-hour shift work) in Iran during an 8-year period to survey descriptive factors of injuries. Methods: Variables collected included accident time, age of injured worker, employment type, work experience, injury cause, educational background, and other information about accidents. Results: Results indicated that most of the accidents occurred in summer, and 51.3% were during shift work. Worker negligence (malpractice) was the cause of 75% of deaths. Type of employment had a significant relationship with type of injuries (p < 0.05). Most injuries were electrical burns. Conclusion: High rate of accidents in summer may be due to the warm weather or insufficient professional skills in seasonal workers. Shift workers are at risk of sleep complaints leading to a high rate of work injuries. Acquiring knowledge about safety was related to job experiences. Temporary workers have no chance to work all year like permanent workers, therefore impressive experiences may be less in them. Because the lack of protective equipment and negligence are main causes of accidents, periodical inspections in workshops are necessary.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• Journal of dental hygiene science
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• v.8 no.1
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• pp.13-20
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• 2008

The purpose of this study was to find out experiences of dental hygienists working on dental care sites, to prevent potential malpractice accidents and disputes, and to examine why it is necessary to provide corresponding education or training courses. As a result, this study came to the following conclusions: 1. It was found that 32.5% had ever experienced in malpractice suits or disputes, and 55.0% of such experienced group had ever experienced in malpractice suits or disputes concerned with dental hygienists. 2. According to inquiry on whether dental hygienists have certain liability for malpractice disputes, it was found that 66.3% respondents ascribed the medical liability to dental hygienists. And according to inquiry for those respondents on liability ratio, it was found that 57.1% of them thought 11%~30% as appropriate liability ratio. 3. According to survey on extent of doubts about potential malpractice accidents and disputes in future, it was found that 72.4% respondents sometimes had doubts about them. 4. It was found that 64.2% respondents thought it necessary and urgent to provide education related to prevention and countermeasures for malpractice disputes.

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

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.139-171
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• 2018

The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

• The Korean Society of Law and Medicine
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• v.11 no.1
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• pp.397-445
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• 2010

This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.209-229
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• 2008

When we are totalizing the lawsrelated to the medical, as the Laboratory medical testing is a kind of the medical act, it is the regulation that the medical technologist can analyze the specimen using in vitro diagnostic devices and diagnosticdrugs under the guidance of doctor or dentist from a corresponding medical institution and can report through verification and interpretation. However, in real medical fields, 'the guidance of doctor' is seriously in-sufficient or even the person who is not the medical technologist is executing. Furthermore the cases that produce inspection results with devices or reagents which are not validated nor approved have been frequently occurred. The result of Laboratory medical testing derived from this procedure can become the important information for the disease control of a country, and also can be decisive to the definite diagnosis and the prognostic monitoring about the patient disease. In spite of its significant medical act to be applicable to an unique proof with the related expert appraisal result in the medical mal-practice lawsuit, our reality in which the quality control is not properly working due by the costs and the labor shortage related to the Laboratory medical testing is quietly in bad condition. Even from now, the government should recognize the significance of the Laboratory medical testing and must achieve more strict administrative management as well as the law maintenance.