Knaak Jan-Paul, Parzeller Markus
Institute of Forensic Medicine, University Hospital, Goethe University, Frankfurt, Germany,
Int J Legal Med. 2014 Nov;128(6):1049-57. doi: 10.1007/s00414-014-0976-2. Epub 2014 Mar 28.
Recent studies on court cases dealing with medical malpractice are few and far between. This retrospective study, therefore, undertakes an analysis of medical malpractice lawsuits brought before regional courts in two judicial districts of the federal state of Hesse.
Over a 5-year period (2006-2010), 232 court decisions on medical malpractice taken by the regional courts (Landgericht) of Kassel and Marburg were evaluated according to medical discipline, diagnosis, therapy, relevant level of care, charge of neglect of duty by the claimant party, outcome of the lawsuit, and further criteria.
With certain overlaps, the disciplines most frequently confronted with claims of medical malpractice were accident surgery and orthopedics (30.2%; n = 70), dentistry (16.4%; n = 38), surgery (12.1%; n = 28), and gynecology and obstetrics (7.8%; n = 18), followed by the remaining medical disciplines (38.8%; n = 90). Malpractice allegations were brought against the practice-based sector in 35.8 % (n = 83) of cases, the hospital-based sector in 63.3% (n = 147) of cases, and other sectors in 0.9% (n = 2) of cases. The allegation grounds included false administration of treatment (67.2%; n = 156), false indication of treatment (37.1%; n = 86), false diagnosis (31.5%; n = 73), and/or organizational negligence (13.8%; n = 32). A breach of duty to inform was given as grounds for the claim in 38.8% (n = 90) of cases. A significant majority of 65.6% (n = 152) of cases ended in a court settlement. Of the cases, 18.9% (n = 44) were concluded by claim withdrawal, 11.2% (n = 26) by claim dismissal and 2.6% (n = 6) by criminal sentence. Of the cases, 1.7% (n = 4) were for purposes of securing evidence.
Although there was no conclusive evidence of malpractice, two thirds of the cases ended in a court settlement. On the one hand, this outcome reduces the burden on the courts, but on the other, it can in the long term give rise to expectations that doctors will accept liability even in cases of inevitable deterioration following due and proper treatment.
近期关于医疗事故诉讼案件的研究寥寥无几。因此，本回顾性研究对黑森州两个司法辖区地方法院受理的医疗事故诉讼进行了分析。
在5年期间（2006 - 2010年），对卡塞尔和马尔堡地方法院做出的232例医疗事故判决，依据医学学科、诊断、治疗、相关护理水平、原告方失职指控、诉讼结果及其他标准进行了评估。
在一定程度上存在重叠，医疗事故索赔最常涉及的学科是事故外科与骨科（30.2%；n = 70）、牙科（16.4%；n = 38）、普通外科（12.1%；n = 28）以及妇产科（7.8%；n = 18），其余医学学科占38.8%（n = 90）。35.8%（n = 83）的案件针对基于诊所的部门提出医疗事故指控，63.3%（n = 147）的案件针对基于医院的部门，0.9%（n = 2）的案件针对其他部门。指控理由包括错误治疗（67.2%；n = 156）、错误治疗指征（37.1%；n = 86）、错误诊断（31.5%；n = 73）和/或组织疏忽（13.8%；n = 32）。38.8%（n = 90）的案件将违反告知义务作为索赔理由。65.6%（n = 152）的案件以庭外和解告终，占绝大多数。其中，18.9%（n = 44）的案件以撤诉结案，11.2%（n = 26）的案件以驳回索赔结案，2.6%（n = 6）的案件以刑事判决结案。1.7%（n = 4）的案件用于证据保全。
尽管没有确凿的医疗事故证据，但三分之二的案件以庭外和解告终。一方面，这减轻了法院的负担，但另一方面，从长远来看，这可能会引发一种预期，即即使在经过适当治疗后仍不可避免地出现病情恶化的情况下，医生也会承担责任。
