Subscribe to RSS
DOI: 10.1055/s-0038-1634365
Legal Pitfalls in Teleneuropathology
Publication History
Received
09 January 2003
Accepted
27 February 2003
Publication Date:
07 February 2018 (online)
Summary
Objectives: This study aims to emphasize legal pitfalls, especially the often underestimated liability issues for both clients of telemedicine and “tele-doctors”. The main relevance of telemedicine lies in its capability to link medical practitioners and remote hospitals to larger or specialized facilities in a very fast electronic manner. This may become even more important due to current increases in subspecialization and the demand for more precise diagnosis and consultation in difficult cases. However, every potential user or client of telemedicine should keep in mind that several questions of law are involved.
Methods: In this paper, two case studies representative of practical teleneuropathology scenarios are described. The assessment of the legal implications is focused on the personal liability of the teleneuropathologist.
Results: The far-reaching personal liability of the teleneuropathologist can lead to situations in which neither the insurance of the hospital nor the private professional liability insurance could be called on to refund possible damages for health impairments of a patient.
Conclusions: In Germany, a contractual exclusion of liability in health matters is not admissible. With regard to the European situation, international agreements such as a European telemedicine law could be conducive to the future border-crossing development of telemedicine though, to date, the legal competencies remain with the single member countries of the European Community.
-
References
- 1 Agbamu DA, Sim E. The data security aspects of telepathology via the Internet have been ignored. Hum Pathol 1997; 28: 1440-1.
- 2 Bundesgerichtshof. Urt. v. 13.02.1992 – III ZR 28/90 (Karlsruhe). Neue Jurist Wochenschr 1992; 45: 2080-4.
- 3 Bundesgerichtshof. Urt. v. 19.03.1992 – II ZR 170/90 (Hamm). Neue Jurist Wochenschr 1992; RR 7: 1011-2.
- 4 Bundesgerichtshof. Urt. v. 29.11.1994 – VI ZR 189/93 (Oldenburg). Neue Jurist Wochenschr 1995; 48: 776-8.
- 5 Bundesgerichtshof. Urt. v. 19.12.1995 – VI ZR 15/95 (Hamburg). Neue Jurist Wochenschr 1996; 49: 1128-31.
- 6 Bundesgerichtshof. Urt. v. 16.03.1999 – VI ZR 34/98 (Bamberg). Monatsschr Deutsches Recht 1999; 53: 675-6.
- 7 Dietel M, Nguyen-Dobinsky TN, Hufnagl P. The UICC Telepathology Consultation Center. International Union Against Cancer. A global approach to improving consultation for pathologists in cancer diagnosis. Cancer 2000; 89: 187-91. [ http://pathoweb.charite.de/UICCTPCC/default.asp ]
- 8 Dierks C, Feussner H, Wienke A. Hrsg. Rechtsfragen der Telemedizin. Schriftenreihe Medizinrecht. Berlin-Heidelberg-New York-Barcelona-Hongkong-London-Mailand-Paris-Singapur-Tokio: Springer; 2001
- 9 Heldrich A. Article 40 EGBGB Rdnr. 4. In: Palandt O. Bürgerliches Gesetzbuch, 62. Aufl. München: C.H. Beck; 2003
- 10 Hoppe JF. Telemedizin und internationale Arzthaftung. MedR. 1998: 462-8.
- 11 Kuszler PC. Telemedicine and integrated health care delivery: compounding malpractice liability. Am J Law Med 1999; 25: 297-326.
- 12 Leong FJ, Nicholson AG, McGee JO. Robotic telepathology: efficacy and usability in pulmonary pathology. J Pathol 2002; 197: 211-7.
- 13 Marchevsky AM, Lau SK, Khanafshar E, Lockhart C, Phan A, Michaels PJ, Fishbein MC. Internet teleconferencing method for telepathology consultations from lung and heart transplant patients. Hum Pathol 2002; 33: 410-4.
- 14 Matthies HK, von Jan U, Porth AJ, Brandis A, Walter GF. Telediagnosis and teleconsultation in neuropathology. In: Lemke HU, Vannier MW, Inamura K, Farman AG. eds. Computer Assisted Radiology and Surgery, pp 464-467. Amsterdam-Lausanne-New York-Oxford-Shannon-Singapore-Tokyo: Elsevier Science; 1998
- 15 Medicus D. Bürgerliches Recht, 19. Aufl., p 47. Köln-Berlin-Bonn-München: Carl Heymanns Verlag; 2002
- 16 Montironi R, Thompson D, Scarpelli M, Bartels HG, Hamilton PW, da Silva VD, Sakr WA, Weyn B, van Daele A, Bartels PH. Transcontinental communication and quantitative digital histopathology via the Internet; with special reference to prostate neoplasia. J Clin Pathol 2002; 55: 452-60.
- 17 Netzer T, Mairinger T, Gschwendtner A, Mikuz G, Markl C. Die rechtliche Lage der Telemedizin in Österreich. Wien Klin Wochenschr 1996; 108: 555-9.
- 18 O’Brien MJ, Takahashi M, Brugal G, Christen H, Gahm T, Goodell RM, Karakitsos P, Knesel Jr EA, Kobler T, Kyrkou KA, Labbe S, Long EL, Mango LJ, McGoogan E, Oberholzer M, Reith A, Winkler C. Digital imagery/telecytology. International Academy of Cytology task force summary. Diagnostic cytology towards the 21st century: an international expert conference and tutorial. Acta Cytol 1998; 42: 148-64.
- 19 Pflüger F. Haftungsfragen der Telemedizin. VersR. 1999: 1070-5.
- 20 Remmelinck M, Lopes MB, Nagy N, Rorive S, Rombaut K, Decaestecker C, Kiss R, Salmon I. How could static telepathology improve diagnosis in neuropathology?. Anal Cell Pathol 2000; 21: 177-82.
- 21 Schiffer M. Juristische Aspekte der Telepathologie. Zentralbl Pathol 1992; 138: 393-4.
- 22 Schöne K. Wer haftet? Haftungsrechtliche Risiken ohne Versicherungsschutz, Teil 1. Mangm&Krhs 1999; 8: 19.
- 23 Schöne K. Wer haftet? Haftungsrechtliche Risiken ohne Versicherungsschutz, Teil 2. Mangm&Krhs 1999; 9: 15-6.
- 24 Schwarzmann P, Binder P, Kaser M, Klose R. European field tests with HISTKOM telepathology equipment. Stud Health Technol Inform 1999; 64: 192-207.
- 25 Sprau H. § 675 Rdnr. 30. In: Palandt O. Bürgerliches Gesetzbuch, 62. Aufl. München: C.H. Beck; 2003
- 26 Stolte M. Schnellschnitt-Diagnostik per Telepathologie“. Gefahr der Verletzung der Fachgebietsgrenzen. Pathologe 1999; 20: 373.
- 27 Szymas J, Papierz W, Danilewicz M. Real-time teleneuropathology for a second opinion of neurooncological cases. Folia Neuropathol 2000; 38: 43-6.
- 28 Terry NP. Cyber-malpractice: legal exposure for cybermedicine. Am J Law Med 1999; 25: 327-66.
- 29 Terry NP. Structural and legal implications of e-health. J Health Law 2000; 33: 605-14.
- 30 Thomas H. § 823, Rdnr. 66 f. In: Palandt O. Bürgerliches Gesetzbuch, 62. Aufl. München: C.H. Beck; 2003
- 31 Tsuchihashi Y, Okada Y, Ogushi Y, Mazaki T, Tsutsumi Y, Sawai T. The current status of medicolegal issues surrounding telepathology and telecytology in Japan. J Telemed Telecare 2000; 6, Suppl 1: 143-5.
- 32 Ulsenheimer K, Heinemann N. Rechtliche Aspekte der Telemedizin – Grenzen der Telemedizin?. MedR. 1999: 197-203.
- 33 Walter GF. Teleneuropathology: a means to improve the correctness of neuropathological diagnoses in clinical practice. Crit Rev Neurosurg 1999; 9: 1-11.