Medico-Legal Analysis of General Surgery Cases in Greece: A 48 Year Study

Abstract

IntroductionSurgery can be dangerous not only for patients, but it also carries a risk for the surgeon in case of medical error, which can affect their future medical career. The purpose of our research is to assess the current situation regarding medical liability in General Surgery in Greece, the reasons for the allegations of medical malpractice as well as the relationship between these issues and the court results. MethodsPublished court decisions of criminal, civil, administrative and disciplinary content were searched in legal information banks, between year 1973 and 2020. Court decisions were analyzed by an expert, a specialist general surgeon and an anesthesiologist, for the causes of death and the correctness of the court decision in collaboration with the lawyers of the investigation. Results588 court decisions were retrieved, out if which 103 (17.751%) criminal (n = 81), or civil and administrative decisions (n = 22) for surgeons. Out of a total of 81 first and second instance criminal cases and appellate court decisions of the Supreme Court, 27 cases concerned negligent homicide, 16 cases concerned negligent bodily harm and seven were acquittals. Out of 22 civil cases decisions, awarding or not awarding compensation, three cases concerned negligent homicide, seven bodily harm and two were acquittals. 11 cases of negligent homicide concerned laparoscopic and bariatric surgical procedures. ConclusionsLaparoscopic surgery represents one of the most important surgical developments in the last 30 years. However, they represent a great proportion of the cases concerning medical malpractice in the greek legal system. It is important to have a national center for reporting misdiagnosis and complications and a medical liability system that will facilitate improved diagnosis, learning from diagnostic errors and delays in diagnosis, in order to avoid similar cases of malpractice in the future.

Medical liability in neurosurgery. greek courts decisions analysis.

“…Out of a total of 52 court decisions, 11 criminal court cases and 10 civil cases involving 7 cases of negligent homicide and 14 bodily injuries were retrieved. The mean duration of litigation in 17 cases was 5.5 (3-9) years, while in 4 cases the duration was 14.5 (12)(13)(14)(15)(16)(17)(18)(19) years. The average compensation paid was € 101,701 (€ 40.00-€ 130,000).…”

“…In our research, 52 court decisions were retrieved concerning 12 criminal cases, 9 civil and 5 acquittals, with 69% of these occurring in the decade 2011-2020. The total number of cases involving neurosurgeons was significantly lower than those in other surgical specialties such as anaesthesia and general surgery (15,16). However, the total number of surgical procedures in neurosurgery in Greece is known to be significantly smaller.…”

Medical Liability in Obstetrics/Gynecology and Co-liability With Anesthesiology in Greece: A Retrospective Study

“…In our research, more cases concerned OB/GYNs compared to the other surgical specialties in Greece [6][7].…”

“…In our research, more cases concerned OB/GYNs compared to the other surgical specialties in Greece [ 6 - 7 ]. The causes of death and bodily injury from poor medical practice varied widely, with bleeding and perinatal asphyxia due to misdiagnosis, delayed diagnosis, or inadequate care being the most common factors.…”

A History of Medical Liability: From Ancient Times to Today

“…The penal penalties imposed, which are of a personal nature (and therefore not hereditary) are either pecuniary or deprivation of liberty, while the compensation, the consequence of civil liability, is of a property nature and is inherited. Another point that can be considered to link in some way civil liability with penal liability is the representation of civil action, an institution that has its roots in civil law and has been introduced in criminal proceedings to strengthen the position of the victim or other actively legitimized persons [ 24 , 25 ].…”