[Surgery of the carpal tunnel reviewed by an expert].
BACKGROUND
The author of this article, who is a hand surgeon and who was appointed to serve at the French Supreme Court in the capacity of expert in assessing cases of medical malpractice examined 357 cases over a 6-year period, and was alarmed at the high incidence of carpal tunnel cases, i.e., 20 in all. The legal and medical aspects of the cases in question have been described.


METHODS
Six cases have been described in detail, and the medical approach in each instance has been commented on and severely criticized. The judgement that was handed down has been included.


CONCLUSIONS
Following this examination, an analysis has been made of the reasons for the instances of medical malpractice. Nearly three-quarters of the cases were directly related to disagreements between medical colleagues or to poor patient management, i.e., the lack of experience in a surgical context. In a quarter of the surgical procedures, technical errors were involved, e.g., nerve section, infection, or further unnecessary surgery.


CONCLUSIONS
The author states that the surgeon should fulfill three main obligations towards the patient: providing the necessary therapeutic means; in all instances ensuring that the patient is fully informed prior to surgery; and also ensuring maximum security. He should act in a truly professional capacity, and be capable of crisis management.
Julliard
F A
FA
D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D002983:Clinical Competence / Q000331:legislation & jurisprudence*; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005602:France; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D008318:Malpractice / Q000331:legislation & jurisprudence*; D019300:Medical Errors / Q000331:legislation & jurisprudence*; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D018579:Patient Selection; D010819:Physician's Role; D012449:Safety / Q000331:legislation & jurisprudence