Gómez-Durán Esperanza L, Mulà-Rosías Joan Antoni, Lailla-Vicens Josep Maria, Benet-Travé Josep, Arimany-Manso Josep
Professional Liability Department, Barcelona's Official College of Physicians, Passeig Bonanova, 47, 08017 Barcelona, Spain.
J Forensic Leg Med. 2013 Jul;20(5):442-6. doi: 10.1016/j.jflm.2012.12.006. Epub 2013 Feb 12.
To identify relevant factors involved in obstetrics and gynecology (OG) professional liability claims to help archive better management of risks.
Analysis of 885 OG claims opened between 1986 and 2010, with the identification of the most common events leading to a claim, the economical and juridical characteristics of the claims, as well as the relevant trends over the study period.
Most claims related to obstetrics. Labor, delivery and its complications accounted for 33.1% of the claims; 12.77% related specifically to cesarean. Oncological diseases, fetus death during labor and delivery, neurologically impaired infant and histerectomy-related problems were the most frequently claimed events. Most cases ended up without an indemnity payment and 37.7% of closed files were solved by an out-of-court procedure. Average payment was higher for the obstetric procedures than for those concerning gynecology cases. The proportion of claims relating to obstetrics increased during the study period, as well as the average payment.
OG is at high-risk for malpractice claims, but compensation awards are not frequent. However, particular events, such as retained foreign objects, tubal ligation, ultrasound diagnosis or neurologically impaired newborns, deserve special attention regarding medico-legal issues.
确定妇产科(OG)职业责任索赔所涉及的相关因素,以帮助更好地进行风险管控。
分析1986年至2010年间受理的885起妇产科索赔案件,确定导致索赔的最常见事件、索赔的经济和法律特征,以及研究期间的相关趋势。
大多数索赔与产科有关。分娩、接生及其并发症占索赔的33.1%;其中剖宫产相关的占12.77%。肿瘤疾病、分娩期间胎儿死亡、神经功能受损婴儿以及子宫切除相关问题是最常被索赔的事件。大多数案件最终无需支付赔偿金,37.7%的结案档案通过庭外程序解决。产科手术的平均赔偿金额高于妇科手术。在研究期间,产科相关索赔比例上升,平均赔偿金额也有所增加。
妇产科存在较高的医疗事故索赔风险,但赔偿裁决并不常见。然而,诸如异物残留、输卵管结扎、超声诊断或神经功能受损新生儿等特定事件,在法医学问题上值得特别关注。