[Autoptically confirmed malpractice cases].

Claims of lethal medical malpractice cases in penal law are mostly dealt with by experts in forensic medicine since in lethal cases the autopsy is crucial for determining the cause of death. Knowledge of the cause of death, in turn, is the necessary basis of an expert opinion on negligence and the causality between negligence and cause of death. Compared to civil lawsuits filed for malpractice and cases dealt with at the arbitration committees of the medical councils penal lawsuits with 1500 to 2000 cases per year are of minor importance. Our own retrospective multicentre study on lawsuits filed for lethal cases of medical malpractice (based on autopsy findings of 4450 cases) revealed an annual increase in autopsies due to medical negligence from 3 to 6 hundred. Hospital doctors are more frequently affected by medical malpractice claims than private-practice physicians. However, the rate of confirmed medical malpractice cases is much higher for doctors in private practice. Although surgeons are most frequently charged with medical malpractice the rate of confirmed medical malpractice cases is comparatively low in surgery. Medico-legal autopsies in cases of alleged medical malpractice are often ordered by the public prosecutor because the manner of death was classified as unnatural or undetermined. Therefore the often-heard reproach that doctors frequently make mistakes and do their very best to hide them is not true. Thus, it has to be recommended that in a case of unexpected death associated with medical treatment the doctor in his own interest should classify the manner of death as undetermined.