Claims about medical malpractices resulting in neonatal and maternal impairment in Iran

Taghizadeh, Ziba; Pourbakhtiar, Maryam; Azimi, Khadijeh; Ghadipasha, Masoud; Kamran, Soltani Arabshahi

doi:10.1016/j.jflm.2019.06.008

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…The most frequently claimed specialties for this reason were obstetrics and gynecology (15 complaints, 19 doctors), general surgery (6 complaints, 10 doctors) and orthopedics and traumatology (7 complaints, 9 doctors), all of them major surgical specialties, which, by their nature, involve an intrinsic risk of the occurrence of additional harm during surgical interventions which are often complex [ 4 ]. Some of the complications are related to the complexity of the disease, but others are related to errors that could have been prevented [ 45 ]. Our results show that women were more likely to claim complications than men and for the complaint to be made by the patients rather than their relatives, probably because the patient is the one who endures the physical suffering associated with the occurrence of a complication and the subsequent necessary treatments.…”

Section: Discussionmentioning

confidence: 99%

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

et al. 2020

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Background and objectives. Medical malpractice is an increasing phenomenon all over the world, and Romania is not spared. This matter is of concern as it has a significant impact on the physicians and the patients involved, as well as on the health care system and society in general. The purpose of our study was to perform an insight analysis on the reasons for medical malpractice complaints as well as the factors that facilitate the complaints to identify specific ways to prevent them and, implicitly, to improve the medical practice. Materials and Methods. The authors conducted a retrospective study of the medical malpractice complaints registered in the period 2006–2019 at the Commission for monitoring and professional competence for malpractice cases in the region of Moldova, Romania, collecting data on both the patients and the medical professionals involved. Results. The authors analyzed 153 complaints directed against 205 medical professionals and identified 15 categories of reasons for complaints, the most significant being related to the occurrence of complications, and to the doctor–patient interaction (e.g., communication, behavior, informed consent). The most frequently reported medical specialties were obstetrics and gynecology, emergency medicine, general surgery, and orthopedics and traumatology. Emergency medicine was often involved in complaints suggesting an over utilization of this department in our country and the need for health policies, which could divert the large number of patients accessing emergency medicine towards primary care. Conclusions. Regarding the dysfunctions in the doctor–patient relationship frequently claimed by patients, the authors concluded that doctors need special undergraduate training and periodic updating during their practice for them to be able to adequately address the challenges of interacting with their patients.

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Section: Discussionmentioning

confidence: 99%

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

et al. 2020

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“…Management of shoulder dystocia was the leading causative issue contributing to the management of birth complications and adverse events (23.3%). Shoulder dystocia always resulted in brachial plexus injury 6,38,39 . Brachial plexus injury occurs during difficult deliveries, mainly caused by improper midwifery in vaginal delivery 40 .…”

Section: Discussionmentioning

confidence: 99%

Improving the Quality of Maternity Care: Learning From Malpractice

Shi¹,

Zhang²,

Huang

et al. 2023

J Patient Saf

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This study aimed to depict the characteristics, injury outcomes, and payment of obstetric malpractice lawsuits to better understand the medicolegal burden in obstetrics and categorize the causes of obstetric malpractice lawsuits using The National Health Service Litigation Authority coding taxonomy for further quality improvement in maternity care. Methods:We reviewed and retrieved key information on court records of legal trials from China Judgment Online between 2013 and 2021.Results: A total of 3441 obstetric malpractice lawsuits successfully claimed were reviewed in this study, with a total indemnity payment of $139,875,375. After peaking in 2017, the number of obstetric malpractice claims begins to decline. Of the 2424 hospitals that were sued, 8.3% (201/2424) were referred to as "repeat defendant" because they were involved in multiple lawsuits. Death and injury were the outcomes in 53.4% and 46.6% of the cases, respectively. The most common outcome type was neonatal death, which made up 29.8% of all cases. The median indemnity payment for death was higher compared with injury ( P < 0.05). In terms of detailed injury outcomes, the major neonatal injury had higher median indemnity payments than neonatal death and fetal death ( P < 0.05). The median indemnity payment of the major maternal injury was higher than that of maternal death ( P < 0.05). The leading causes of obstetric malpractice were the management of birth complications and adverse events (23.3%), management of labor (14.4%), career decision making (13.7%), fetal surveillance (11.0%), and cesarean section management (9.5%). The cause for 8.7% of cases was high payment (≥$100, 000). As indicated by the results of the multivariate analysis, the hospitals in the midland of China (odds ratio [OR], 0.476; 95% confidence interval [CI], 0.348-0.651), the hospitals in the west of China (OR, 0.523; 95% CI, 0.357-0.767), and the secondary hospitals (OR, 0.587; 95% CI, 0.356-0.967) had lower risks of high payment. Hospitals with ultimate liability (

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“…Peripartum injuries are unacceptable to the public, irrespective of iatrogenic complications or fateful events during difficult vaginal births, and are often the cause of litigation due to a priori problems in malpractice from historical records to the present [20]. For example, Iranian authors presented a forensic study on 299 cases, of which 33.34 % were cerebral palsy, 24.24 % Erb's palsy due to FSD, and 17.2 % due to complications related to episiotomy [21].…”

Section: Discussionmentioning

confidence: 99%

A Forensic Aspect of Fetal Shoulder Dystocia

Habek

Cerovac

2020

Z Geburtshilfe Neonatol

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Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's pelvis and the child, i. e., an anthropometric disorder of delivery mechanics and dynamics. It is evident that the need to perform other maneuvers indicates the severity of FSD, which in turn correlates with the consequent iatrogenic injury of the fetus and/or mother. FSD is certainly the most controversial forensic obstetric problem, with the most disputes, compensation for damages due to peripartum injury to the child and/or mother, pain suffered, the need for someone else's care, and permanent disability. Suboptimal procedures and inadequate documentation are factors of forensic risk and subsequent litigations. Prevention of FSD is generally not possible, although good antenatal care can sometimes exclude risky cases of FSD, and some rare, chronic intrauterine disorders can result in orthopedic and neurological sequelae, which is especially important in forensic analysis. Because FSD is largely impossible to predict, it must be viewed as an intrapartum acceptable risk. During childbirth, FSD may compromise the safety of the mother and unborn child, therefore education and skills acquisition are necessary for obstetric work. Risk control, proper procedures, and proper documentation, along with good communication with the pregnant women and their families, significantly reduce litigation procedures.

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Claims about medical malpractices resulting in neonatal and maternal impairment in Iran

Cited by 7 publications

References 17 publications

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

Improving the Quality of Maternity Care: Learning From Malpractice

A Forensic Aspect of Fetal Shoulder Dystocia

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