Medicolegal Aspects of Obstructive Sleep Apnea/Hypopnea Syndrome
Despite frequent speculation by speakers at national medical meetings that physicians may be held legally liable for accidents caused by patients with obstructive sleep apnea/ hypopnea syndrome (OSAHS) who have not been promptly diagnosed and treated, very little has been published on the topic. A patient involved in a drowsy driving accident resulting in serious injury or death is the most likely situation in which physicians could face charges of legal negligence in relation to management of a patient with OSAHS. State regulations for physician reporting of patients with medical conditions that may render them unfit for driving safely vary from “no requirement” to mandatory reporting of all patients with a diagnosis listed as reportable. In two instances in Ontario, Canada, physicians were found liable because of failure to report potentially medically unfit patients to authorities before the patient had automobile crashes (1). In New Jersey, falling asleep at the wheel and driving while “fatigued” can be considered reckless driving (Maggie’s Law), with fatigued defined as having had no sleep for more than 24 conservative hours. American Medical Association policy H-15.958 (Fatigue, Sleep Disorders, and Motor Vehicle Crashes) states that physicians should “inform patients about the personal and societal hazards of driving or working while fatigued and advise patients about measures they can take to prevent fatigue-related and other unintended injuries.” It also states they should “become familiar with the laws and regulations concerning drivers and highway safety in the state(s) where they practice” (2).
KeywordsObstructive Sleep Apnea Continuous Positive Airway Pressure Obstructive Sleep Apnea Syndrome Epworth Sleepiness Scale Obstructive Sleep Apnoea
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