ADVERSE EVENTS IN OBSTETRICS: CLINICO-LEGAL REVIEW OF THE ALLEGED MEDICAL MALPRACTICE CASES
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8797Keywords:
medical malpractice, medical errors, dereliction of duty by the medical personnel, analysis.Abstract
The aim of the study – to evaluate the medical malpractice litigations provided by obstetricians in Ukraine.
Materials and Methods. A retrospective review of all alleged medical malpractice cases (350 in total) between 2007 and 2016 handled at Ternopil, Zhytomyr and Chernivtsi Regional Bureaus of Forensic medical Examination, was performed.
Results and Discussion. Approximately a quarter of all medical malpractice litigations (23.4 %) were initiated against obstetricians and gynecologists. Lacks of health care provision committed by obstetricians were detected in 70.5 % of the cases. Unreasonable medical care occurred in cases of difficult obstetric situation associated with the pathology of the fetus or mother. Most often disadvantages are happening during childbirth, in the prenatal period, at the time of surgery or anesthetic provision. Unintentional medical care was confirmed by forensic medical expert commission as a rule in medical procedures or medical treatment (28.2 %), diagnostics (23.0 %). Mistakes in medical records were detected in (26.3 %) of the cases, institutional errors – (16.7 %), ethical errors – (5.8 %). Insufficient or incomplete medical care provided by obstetricians seemed more frequently (74.5 %), inopportune medical care – 36.4 %, unskillful medical care 20.0 %. A professional portrait of unskilled obstetrician was investigated too. Severe consequences for the patients took place in majority of the cases (92.70 %). A causal relationship between the damage claimed by the patient or his family and improper medical care were found in 23.6 % cases.
Conclusions. Obstetricians are in the top of physician specialties involved in claims most often in Ukraine. Diagnostic and institutional errors, improper performance of medical procedures and medication errors are seemed most frequently in medical malpractice cases in obstetrics. The majority of the medical mistakes became due to different objective reasons. Approximately a half of all of the studied cases faced together with breach of standards of care followed by the poor quality of the medical personnel.
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