بررسي يكصد شكايت پزشكي عليه تيم جراحي رسيدگي شده در سازمان نظام پزشكي مشهد

Analysis of 100 Malpractice Claims Against Surgical Team Judged at Mashad Medical Council.

Introduction & Objective: Many physicians are afflicted with malpractice claims dilemma during their course of practicing medicine. The purpose of this study is acquainting surgical team including surgeons and anesthesiologist (as the high risk group) with different aspects of this matter. Materials & Methods: First, all malpractice claims received by Medical Council of Mashhad during 1999 through 2003 were classified according to defendantʹs speciality. Then data about patient, physician, disease, management, litigation, and judicial authority were obtained from the latest 100 malpractice claims settled at Medical Council of Mashhad in which surgeon or anesthesiologist was sued. Data were analyzed by SPSS software using frequency distribution charts, ANOVA, Studentʹs t, chi-square, and Logistic Regression tests. Results: In 1057 lawsuits during a five years period (1999-2003) 56% were against surgical team, while only 13% were against other phyisicians (the remaining were against dentists and paramedical workers). In 100 cases studied, mean age of patients was 35.4±18.2 years; 45 cases were male ; 40 cases were managed as an emergency; 61% of adverse events leading to litigation were known complications of disease or treatment and only 11% were due to negligence.There were 56 morbidities and 31 mortalities leading to litigation. Only 30% of dead patients were referred for autopsy. The mean time between treatment and litigation was 6 months. Half of litigations were against private hospitals, and most were about surgical procedures (75%). In 77% of litigations the quality of medical care was proper. Mean investigation time at Mashad Medical Council was 9.3±7 months. Nine lawsuits ended in favour of plaintiff. Independent risk factors of defendantʹs incrimination were occurrence of adverse event due to negligence, and substandard quality of medical care. Conclusions: Malpractice claims are 4.3 times more common against anesthesiologsist and surgeons than internists. Since most of litigations are about accepted complications and in most cases proper management were performed, it seems likely that improving physician - patient relationship will decrease number of malpractice claims against surgeons.