EXPERT EVALUATION IN HEALTH CARE DAMAGES: “MEDICAL ERROR”
submitted July 21st 2019 accepted July 26th 2019
Viviam Paula Lucianelli Spina (1)
Élcio Rodrigues da Silva (1)
Lucas Pedroso Fernandes Ferreira Leal (2)
Jonas Aparecido Borracini (1)
Fabio Tadeu Panza (2)
(1) Médico Perito Oficial do Juizado Especial Federal de São Paulo (JEF-SP) e do Instituto de Medicina Social e de Criminologia do Estado de São Paulo (IMESC), São Paulo-SP.
(2) Médico Perito Oficial do Instituto de Medicina Social e de Criminologia do Estado de São Paulo (IMESC), São Paulo-SP.
Damages associated with health care commonly known as “medical error” are the object of concern and study worldwide, being identified by the increase in hospital stay, the occurrence of temporary or permanent damage, and may even lead to death of the patient. . They increase the costs related to assistance and motivate administrative, ethical and disciplinary investigations and judicial demands for civil and criminal liability. The present analysis aims to standardize the concepts and method used in the expert assessment, defining parameters of appreciation, in a multiprofessional and systemic perspective. Non-systematic research was conducted on scientific articles in a PubMed database from 2000 to 2019, medicine textbooks, international guidelines, and national legal regulations regarding patient safety and health care-related harm. There is international technical-scientific consensus on adopting the term health-related harm rather than medical error. The parameters of expert analysis listed were the evaluation of care within the technical perspective of the doctrine and the care protocols, the environmental factors of infrastructure and organizational service provider, the human factor in the performance of the health professional, the individual (biological) characteristics, and the external factors. Keywords: health care-related harm, medical error, patient safety, health quality, adverse event.
Keywors: medical error, health care, medical damages, legal medicine