Malpraxis en Urología : lecciones en seguridad clínica y jurídica

espanolOBJETIVO: La informacion disponible sobre reclamaciones por presunta responsabilidad profesional medica (RPM) en urologia es limitada en nuestro entorno y supone una fuente potencial para aprender del error. METODOS: Se analizaron las reclamaciones por presunta mala praxis en Urologia gestionadas en el Consejo de Colegios de Medicos de Cataluna entre 1990 y 2012 evaluando especificamente las caracteristicas clinicas y medico-legales de los casos con RPM. RESULTADOS: Se hallaron 182 casos en 22 anos, con una tasa de RPM del 25,74%. Destacan por su frecuencia y tasas de RPM el error diagnostico en torsion testicular, el embarazo postvasectomia y las complicaciones de las litiasis. Fueron reclamados un total de 246 facultativos, un 89% varones y con una edad media de 45,6 anos. La mayoria de expedientes (n=137, 75,27%) se tramitaron por via judicial. DISCUSION: La Urologia posee un riesgo medio de reclamacion, con una tasa de responsabilidad profesional medica y cuantia en las indemnizaciones moderada. Existen actuaciones especificas susceptibles de mejoras en seguridad clinica, fundamentalmente en patologias del area testicular, vasectomias y litiasis, debiendo obligatoriamente intensificarse la atencion a la adecuada informacion al paciente EnglishOBJECTIVES: Data about urology malpractice claims in our environment are scarce and should be considered a potential opportunity to “learn from errors”. METHODS: We analyzed every claim for alleged malpractice in Urology managed by the Council of Medical Colleges of Catalonia between 1990 and 2012, and specifically evaluated the clinical and medicolegal features of those cases with medical professional responsibility. RESULTS: We identified 182 cases in 22 years, but only the 25,74% showed professional liability. Testicular torsion misdiagnosis, pregnancies after vasectomy and complications of lithiasis should be noted for their frequency of claims and rate of liability. 246 physicians were involved, 89% were males and mean age was 45.6 years. Most cases (n=137, 75.27%) were processed in the courts. DISCUSSION: Urology has a medium risk of claims, with a moderate rate of medical professional liability and amount of compensation. There are specific actions that would lead to clinical safety improvements, particularly in testicular pathologies, vasectomy and lithiasis. Finally, more attention should be paid to proper patient information.