do hospitals need to improve credentialing for robotic surgery

While operating rooms across the U.S. are almost always changing thanks to the semi-regular development of new processes and enhanced surgical tools, this transformation has become especially dramatic over the last ten years thanks to the advent of robotic surgical systems like the da Vinci.

As we discussed in a previous post, the da Vinci, manufactured by Intuitive Surgical, is a robot outfitted with three to four arms — all of which are outfitted with tiny surgical instruments and cameras — that is controlled by a surgeon sitting at a nearby computer station. It is designed to perform a host of less invasive and altogether more patient-friendly laparoscopic surgeries.

While systems like the da Vinci have changed the art of surgery, they have also raised a host of important legal questions.

In particular, questions have arisen as to who exactly is liable in the event a patient suffers a catastrophic surgical error while undergoing a robotic surgery procedure. The physician? The hospital? The maker of the robotic surgery system?

Interestingly, the prevailing view among many experts, thanks to a recent court case, is that liability rests primarily with the physicians and the hospitals. They also argue, by extension, that it falls on the hospitals to ensure that the surgeons they want to grant privileges to perform these robotic surgeries have the necessary training.

This may seem simple enough, but experts indicate that hospitals will have to do much more to ensure their surgeons have the necessary credentialing for robotic surgery given that the more traditional methods, such as relying on board certification, may no longer be sufficient given the rapid pace at which technology evolves.

Indeed, the primary recommendation made by experts is for hospitals to not rely on the training provided by the manufacturers of the robotic surgery systems, but rather to evaluate whether existing internal programs or external programs (board certification, training sessions offered by professional organizations, etc.) are sufficient. If they are not, hospitals must then look to developing new and altogether innovative approaches to credentialing for robotic surgery procedures, such as a peer review process.

Given that 25 states, including Pennsylvania, recognize “negligent credentialing” as a valid basis for a medical malpractice claim against hospitals, it’s likely officials whose institutions have invested millions in these robotic surgery machines will want to start paying very careful attention to this issue.

As a patient, what are your thoughts on robotic surgery and liability?

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