Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014

Glaser, L.M.; Alvi, F.A.; Milad, Magdy P.

doi:10.1016/j.ajog.2017.05.037

Cited by 42 publications

(33 citation statements)

References 14 publications

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“…These are the increase in the less-skilled providers that manage vaginal delivery of twin pregnancies and the prejudice of the involved infertility providers that may affect women’s decisions regarding mode of delivery [18,19]. Additionally, the change that occurred in medico-legal milieu during the last two decades is probably a concern [[20], [21], [22]]. Both factors are possibly related as well.…”

Section: Commentmentioning

confidence: 99%

Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

Zafran

Peretz

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective To examine the trend of cesarean delivery (CD) rate among twin pregnancies and the trend in maternal and neonatal morbidities within two decades. Study design Population-based cohort study, conducted at a single teaching hospital in Israel on data between January 1995 and December 2015. All pregnant women with twin gestation who delivered at a gestational age of 24 weeks or more were included. Data on mode of deliveries, Apgar score <7 at 5 min, cord artery pH < 7.1, early postpartum hemorrhage, blood transfusion, and intrapartum fever for each year were extracted and plotted, and trends were analyzed. CDs performed for one or both twins were divided to laboring, i.e., after a trial of labor, and non-laboring CDs. Data was obtained from the hospital discharge register with ICD-9 codes and crosschecked with the labor medical records. The Cochran-Armitage Trend Test was used to identify trends and correlations. Results Of all 88,145 deliveries that took place during this period, 1955 (2.2%) were twins. Of these 53 were ineligible and were excluded. There was a statistically significant trend (increase) in twins birth over time (p = 0.004). CD rate increased significantly from 43.4% in 1995 to 66.0% in 2015 (p = 0.001). This increase was observed only among non-laboring cesareans (p = 0.001). Multivariate logistic regression analysis revealed that maternal and early neonatal morbidities examined did not differ significantly during the study period. Conclusion Non-laboring CD rate increased significantly over the past two decades among twin pregnancies. Despite this increase, maternal and early neonatal morbidities did not change.

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Section: Commentmentioning

confidence: 99%

Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

Zafran

Peretz

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Seventy per cent of the neonatal sentinel events reported stemmed from poor communication or teamwork 3. Overall, suboptimal practice in obstetrics costs the US healthcare system millions of dollars every year in litigation, especially in the fields of operative delivery (vacuum or manually assisted) and caesarean section 4. A recent report by the Healthcare Insurance Reciprocal of Canada (HIROC) and the Canadian Medical Protective Association (CMPA) notes that obstetrics is one of the highest risk clinical areas, accounting for 45% HIROC and 25% CMPA of liability costs.…”

Section: Introductionmentioning

confidence: 99%

Interventions for improving teamwork in intrapartum care: a systematic review of randomised controlled trials

Tang

Etherington³

et al. 2019

BMJ Qual Saf

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BackgroundThe labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics.MethodsThis systematic review identified and assessed randomised controlled trials (RCTs) of interventions aimed at improving teamwork among interdisciplinary teams in obstetrical care. Medline, CENTRAL, CINAHL and Embase were searched for studies evaluating one of: patient outcomes, team performance or processes of clinical efficiency. Identified citations were reviewed in duplicate for eligibility.ResultsNine RCTs met the inclusion criteria; five of these RCTs were conducted under simulated clinical environments. Simulation-based teamwork training interventions were the most represented (n=7 studies, 3047 healthcare providers (HCPs), 107 782 births), followed by checklists (n=1 study, 136 HCPs) and an electronic-based decision support tool (n=1 study, 296 HCPs). Simulation-based teamwork training was found to improve team performance in 100% of relevant studies (3 of 3 studies assessing team performance) and patient morbidity in 75% of relevant studies (3 of 4 studies assessing patient morbidity). However, no direct mortality benefit was identified among all the studies reviewed. Studies were assessed to be of low-moderate quality and had significant limitations in their study designs.ConclusionWhile the evidence is still limited and from low to moderate quality RCTs, simulation-based teamwork interventions appear to improve team performance and patient morbidity in labour and delivery care.PROSPERO Trial registration numberCRD42018090452

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“…The availability of an efficient, up to date, and moralistic system for investigating professional infringement in the provision of reproductive health services that includes a wide range of clients is a key guide to identify the violation, make a fair decision, and respect the rights of the recipient and the provider of services (63). Continuous education and training of perinatal nurses, identifying high-risk patients and their precise nursing care, improving the quality and standard of delivery through holding complaints assessment committees and precise RCAs of these types of complaints, providing health education to pregnant women, and precise completion of clinical records are among other methods of reduc-ing medical defects in the fields of gynaecology and obstetrics (14,64,65).…”

mentioning

confidence: 99%

Medical malpractice in Iran: A systematic review

Raeissi

Mirghaed

Sepehrian

et al. 2019

Med. J. Islam. Republ. Iran

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Background: Medical malpractice represents a serious problem in the health system and is one of the risk factors for patient safety which damages the patient and increases costs for the patient and the health care provider. The importance of these complaints against physicians is that litigation may continue for a long time and become problematic for patients and physicians. The objective of this study was to investigate the complaints of medical malpractices which were referred to Iran Medical Council to provide solutions to reduce the complaints and improve service delivery. Methods: Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases, such as MagIran, SID, and Irandoc, were searched from 01/01/1990 to 07/01/2018. Also, the grey literature (via Google Scholar) was searched. Studies written in English or in Persian were searched, and keywords used included malpractice, negligence, medical malpractice, physician impairment, Iran, and professional impairment. Results: Nearly 1455 complaints (36%) of the total number of 3977 complaints were proved to be medical malpractice, and physicians were acquitted in 2542 (64%) cases. Most complaints were from gynaecologists, accounting for 43% of all complaints, followed by orthopaedic specialists who ranked second with 21.4% of the total complaints. The most type of failure was due to lack of skill (30.4%), followed by negligence (29.2%). Imprudence or indiscretion (26.3%) and noncompliance with governmental requirements (14.1%) were also in the next ranks, respectively. Conclusion: Improving patient and physician relationships, observing medical ethics, increasing the scientific and technical skills of the medical staff, and following the guidelines and medical protocols will prevent medical malpractice. Therefore, health policymakers can reduce errors and failures by adopting continuing education on medical, ethical, and legal issues.

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Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014

Cited by 42 publications

References 14 publications

Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

Interventions for improving teamwork in intrapartum care: a systematic review of randomised controlled trials

Medical malpractice in Iran: A systematic review

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