The medico-legal implications in medical malpractice claims during Covid-19 pandemic: Increase or trend reversal?

Abstract

The Covid-19 pandemic caused a marked increase in admissions to intensive care units. The critically ill patients’ condition from the infection resulted in their deaths. The healthcare facilities have got into trouble because of the pandemic. In fact, they had to create additional beds in a very short time and to protect health workers with personal protective equipment. Healthcare professionals fear that there will be an increase in complaints and medico-legal malpractice claims and hence they have urged politicians to discuss this. The Italian Parliament recently debated the topic of medical liability and passed the Decree-Law no. 18 of 17 March 2020 (DL – so called Cura Italia) by which they want to extend the concept of “gross negligence” to healthcare facilities. Several Extended Care Units have suffered from outbreaks of Covid-19, so the Prosecutor’s Office of several cities initiated investigations against them. This situation has reached Sicily, where the Prosecutor’s Office of Palermo has opened an inquiry against an Extended Care Unit. Simultaneously, the Covid-19 pandemic may change patients’ attitudes towards healthcare professionals, who are risking their lives daily. So the Italian medico-legal community is debating these questions, with one last pending question remaining: is the number of medico-legal claims likely to increase or trend down?

Take-Home Messages from the COVID-19 Pandemic: Strengths and Pitfalls of the Italian National Health Service from a Medico-Legal Point of View

“…In the course of a pandemic, reaching a high level of care safety [ 14 , 15 ] may prove to be a complex challenge [ 16 ]. It is clear that healthcare professionals have concerns regarding professional liability disputes that arise due to pandemic-related issues [ 17 , 18 , 19 ]. During this particular pandemic, several countries have contemplated creating a legal shield that limits the professional liability of healthcare personnel throughout this emergency situation [ 20 , 21 ].…”

Physicians Professional Immunity in the COVID-19 Pandemic. Problems and Solutions

“…The relationship of trust between patients and doctors could be affected by the debates on professional immunity (Bilotta et al, 2020). We agree that this is a real risk, it being added to other causes that we believe could contribute to increasing distrust.…”

“…The COVID-19 pandemic brought with it a series of new challenges for health professionals, the new conditions for carrying out the activity having associated a series of unique problems which aim at professional liability. For example, Bilotta, Zerbo, Perrone, Malta, & Argo (2020) presents an analytical approach of the factors that have a negative impact on the safety and quality of medical services, indicating: (a) structural problems caused by the need to reconfigure medical services in a short period of time (derogation from the accredited circuit form, dependence of resources allocation to the possibility of procurement, derogation from the staff recruitment based on competence criteria), (b) continuous change of case definition and suspicious cases, (c) absence/ PPE deficit, and (d) decrease of average level of staff experience: some experienced staff end up being infected and isolated, while the new employee faces the lack of experience (Bilotta et al, 2020). Along with a new danger addressed to all citizens, we are witnessing an increase in the risks faced by health professionals during the pandemic (Al-Azri, 2020), some of them aiming the inadequacy of professional responsibility to the concrete conditions of their activity.…”

Uncovering the Veils of Maya on defensive medicine, litigation risk and second victims in surgery: care for the carers to protect the patients

“…hunto nak.com/en/covid -19-track er.html), the majority (64.4%) consisting of "wrongful deaths." We speculate that there will be a rise in COVID-related litigation after the peak phases of the pandemic [10,11].…”

“…In addition, the pandemic has meant that surgeons have had to work under pressure and in very unusual conditions, conditions for which there has been no training [8,9]. As of 5 November 2020, 135 health complaints can be tracked in the USA (https://www.huntonak.com/en/covid-19-tracker.html), the majority (64.4%) consisting of “wrongful deaths.” We speculate that there will be a rise in COVID‐related litigation after the peak phases of the pandemic [10,11].…”