Pratica Medica & Aspetti Legali
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Nel merito dei rapporti medico legali vigenti tra le assicurazioni sociali: la gestione della malattia, la surrogazione e il cumulo tra prestazioni previdenziali nella loro concreta applicazione.
No full textThe article looks at the relationships between the two main Italian Social Security Insurance Institutes: the National Institute of Social Security (INPS) and the National Institute for Insurance against Accidents at Work (INAIL).The aim of the article, resulting from the daily working practices of the two Authors, is to examine the various sectors in which the two institutions are often confronted: the management of compensable illness, the subrogation, and the cases of accumulation of social security benefits provided by the two institutions for disabled persons.Some practical examples are reported in order to facilitate the reader the easy understanding of the issues addressed
Profili di responsabilità infermieristica in un caso di amputazione dell’avambraccio da errata pratica infusionale in neonato prematuro
No full text[Nursing responsibility profiles in a case of forearm amputation by wrong infusion practice in a premature newborn]This article refers to the case of a premature newborn twin (23 weeks of gestation + 6). Of the two brothers, only one survived, in a highly compromised state of health that led to a notable and dramatic series of clinical events: infectious complications, chronic renal failure, viscera herniation, intestinal perforation, and thrombocytopenia, treated with various infusions of platelet concentrates.During an infusion of platelet concentrate, an extravasation occurred with important tissue infarction. The lesion created, secondary to ischemic necrosis, evolves into dry necrosis, from the hand to the whole forearm, and leads to the amputation of the right forearm, despite the various attempts, pharmacological and surgical, experienced to avoid the extrema ratio.The purpose of this article is to analyze what happened considering scientific clinical evidence and the profile of responsibilities related to nursing practice
"Malasanità": breve osservazione a proposito di un singolare quesito posto ai Consulenti Tecnici d’Ufficio in un caso di accertamento tecnico preventivo ex art. 8 della cosiddetta Legge Gelli-Bianco
No full text["Malasanità": brief observation on a singular question posed to Technical Consultants in a case of prior technical assessment pursuant to art. 8 of the so-called Legge Gelli-Bianco]Abstract non presente. Si riporta l\u27inizio dell\u27editoriale Nel luglio del 2018 il Giudice di un Tribunale riceveva istanza di accertamento tecnico preventivo ex art. 8 della cosiddetta Legge Gelli Bianco (Legge n. 24/2017) [1], che, come è noto, impone, a chi voglia esercitare di fronte al Giudice «un’azione risarcitoria derivante da responsabilità sanitaria, di tentare prima un percorso negoziale al fine di verificare la possibilità di evitare il processo» [2]. Nel caso in questione, il Giudice adíto, ai Consulenti Tecnici d’Ufficio (CTU) nominati poneva il seguente quesito: «Accertare l’entità delle lesioni e postumi permanenti residuate al signor XY a seguito dellamala sanità, il nesso di causa tra le lesioni lamentate e l’operato dei sanitari Usl, nonché la congruità delle spese mediche, la necessità di spese mediche future in modo da addivenire ad una composizione della lite»
Alcuni primi rilievi di interesse medico legale in merito alla Legge n. 24 del 2017 sulla responsabilità sanitaria
No full text[Some early reliefs of legal medical interest regarding Law no. 24 of 2017 on healthcare liability] In this paper, the author describes the new Italian law (law n. 24/2017) about health care security and health professionals liability.This law states that the rule of heath professionals is strictly regulated by evidence-based clinical practice guidelines or similar recommendations. Nevertheless, the new law tends to impose to the hospital and health and social care structures (public and private) a strict liability for the health professionals fault.Health professionals liability insurance coverage is assured by health and social care structures. Reducing litigation costs through alternative and mandatory dispute resolution process is the most important target of this law.
Autodeterminazione e responsabilità sanitaria: le trasfusioni di sangue nei pazienti Testimoni di Geova
No full text[Self-determination and medical liability: blood transfusion in Jehovah\u27s Witnesses patients] The present article begins with a brief analysis of the biblical reasons why Jehovah\u27s Witnesses refuse transfusions, to analyze the right to self-determination of a patient, which is exercised through the express informed consent to medical treatment.Then, the article examines three situations that a doctor who is treating a Jehovah\u27s Witness may face: a non-urgent clinical situation that allows different treatment choices; a condition that requires treatment choices obliged but deferrable over time; and, finally, a situation that forces the doctor to a single therapeutic choice not postponed and predictable
L’anagrafe dell’handicap della Provincia autonoma di Trento: aggiornamento dei dati al 31 dicembre 2016
No full text[The register of the handicap of the Autonomous Province of Trento: updating the data as of December 31, 2016] The Authors, examining the Italian welfare system and the contents of Law 104/92 (“Framework Law for assistance, social integration, and rights of the handicapped”), present a statistical analysis of the handicap database in Province of Trento.The Law 104/92 aims, among others, at guaranteeing the respect for human dignity, as well as the rights to freedom and autonomy of persons with disabilities, while promoting their integration in families, schools, work and society; preventing and removing negative conditions that stop the human development, the highest possible level of autonomy and participation in social life, as well as the enjoyment of civil, political and patrimonial rights; achieving a functional and social rehabilitation of people with physical and sensory impairment, while ensuring adequate services and prevention, care and rehabilitation measures, as well as a legal and economic protection; preparing adequate initiatives to overcome marginalization and social exclusion
Implicazioni medico legali della terapia oncologica ai fini valutativi in ambito assistenziale e previdenziale
No full textOncological therapies, i.e. the set of heterogeneous methods to counter the growth and spread of cancer, may become themselves the cause of work disability or inability to perform the activities of daily living (ADL).The paper analyzes various therapeutic approaches to neoplastic diseases in order to examine the major side effects related to the genesis of disability in working activities or inability to perform the ADL.Through the description of some cases came to the observation of the medico-legal department of the Italian National Welfare Institute (INPS) in Siena, the paper aims to explain the relationship between cancer treatments and the so called “oncological iatrogenic disability”.The authors develop a critical analysis of the medico-legal requirements that the side effects of the oncological therapies must have to be recognized as “oncological iatrogenic disability”: certainty of the causal link, intensity and frequency, permanency, and uniqueness of the case
La malattia comune nei lavoratori agli albori di un cambiamento epocale: l\u27INPS quale gestore unico della malattia indennizzabile
No full textThe article looks at the history of medical inspection visits in Italy, and describes in detail, the regulations that have been passed over the years relating to the management and control of common compensable illnesses: in the private sector, which has always been run by the National Institute for Social Security (INPS) which manages the system using its own "listed" occupational health physicians; and in the department of public administration which, until August 2017, saw management entrusted to the same public administrations with the help of medical staff from the Local Health Authority (so called Aziende Sanitarie Locali - ASL), who were operating in the capacity of official medical inspectors.As of 1 September 2017, in accordance with Legislative Decree No. 75 of 27 May 2017, the INPS will conduct all management and inspection of compensable common illnesses, in both the private and the public sectors. A nascent "single official medical inspection center" is thus taking its first insecure steps, against a backdrop of organizational uncertainties and the recognition of an increased workload for an entity which, for many years, has handled invalidity support in Italy
Nurse staffing e responsabilità professionale: quando l’organizzazione è il vero imputato
No full text[Nurse staffing and professional responsibility: when the organization is the real accused] The continuous perception of organizational failure, in terms of human resources adequacy, often generates professional and ethical upsets in health professional workers. Moreover, the perception of insecurity for their own actions, with particular regard to clinical-care needs of assisted people, is ever present.The international literature thoroughly examines the safety limits of the organizations, by giving clear guidance on policy and organizational decisions to pursue.Clinical case report dramatically confirms what the literature describe
La tutela previdenziale della tubercolosi extra-lavorativa: sorpassati concetti medico-legali a fondamenta delle indennità per una malattia ancora in auge
No full textThe Author briefly summaries the legislative history of Italian social security cover for extra-occupational tuberculosis, and lists the economic benefits that the National Institute of Social Security (INPS) reserves for the individuals who are insured with it and suffer from this disease, describing both the administrative and health requirements. Thus, the publication attempts to place the purely conceptual medical-legal aspects on which social security for extra-occupational tuberculosis is based under the microscope of rational criticism; in this way, the medical and legal foundations for the prevalence of morbidity are examined, to reveal the anachronistic principles of a protection that, with current changes in social, geopolitical and labour dynamics, remains based on laws from the 1930s and 1970s, and the principles they expressed