Litigations for Complications of Percutaneous Coronary Intervention: Probability and Consequence Attribution
When performing a cardiac catheterization for a patient, a team equipped with extra-corporeal membrane oxygenation (ECMO) device must be arranged in advance to ensure that the patient can receive support from it within 20 minutes once complications occur. If the physician performs a cardiac catheterization without the prior arrangement, it is a violation of the duty of care and creates an unacceptable risk of death. It is still true, even though there are no written laws or regulations that have clear requirment for this. However, in the case of complications during cardiac catheterization, even timely use first-aid from ECMO, there are still 90% of the mortality rate. Therefore, when the death result appears, it is difficult to attribute the result to the obligation violation, which didn’t arrange any support from the ECMO team (the lack of relevance of obligations violation). In other words, although the defendant during cardiac catheterization created an unacceptable risk of death, it was still impossible to determine that the death result was caused by this risk. For that reason, the consequence attribution cannot be affirmed, so there is no case of offence of negligent manslaughter.