Improved Outcomes in Colon and Rectal Surgery part 17. Written by many of the worlds leading colorectal surgeons, this evidence-based text investigates the risks and benefits of colorectal surgeries. By using clinical pathways, algorithms, and case discussions, the authors identify the best practices for patient safety and positive outcomes to ensure that physicians correctly recognize potential problems and carefully manage complications | 14 Medical legal issues Charles F Gay Jr and Terry C Hicks CHALLENGING CASE A 60-year-old woman with a strongly positive family history of colorectal cancer undergoes a colonoscopy. She has a cm pedunculated polyp snared from the transverse colon. Five days after the procedure she presents to the emergency room with a lower GI bleed. She is hemodynamically stable and you admit her for observation. She remains stable and is discharged 2 days later with no further bleeding episodes. The hospital risk manager calls you to discuss this case. COMMENTS When you meet with the risk manager you inform her that you had seen the patient in your office before the procedure. During this office visit you had discussed with the patient her risk factors indications for the procedure details of the procedure and potential risks. This conversation was documented in your office note and the patient signed a consent for the procedure. The procedure was performed in the usual fashion. You feel that you have a good relationship with the patient and the records are well documented. Although any untoward outcome could lead to litigation the risk manager agrees that you have taken the appropriate actions to minimize your risk. INTRODUCTION As surgery enters the next millennium it finds itself at the crossroads of a serious medical liability crisis. This chapter will briefly review important aspects of the United States medical liability situation and then addresses some risk-prevention techniques for colorectal surgeons. This includes a general overview of the legal process pertaining to medical malpractice issues and tips to help prevent and defend such cases. It is intended to provide practical information that can be used by medical care providers. MAGNITUDE OF THE PROBLEM A lack of affordable liability insurance is leading some doctors to retire prematurely relocate their practices to nonlitigious areas practice without insurance or drop risky procedures. Some of the specific .
