Theissen A, Fuz F, Carbonne B, Bonnet L, Rouquette-Vincenti I, Niccolai P, Raucoules-Aime M
Service d'anesthésie-réanimation, centre hospitalier Princesse-Grace, 1, avenue Pasteur, 98000 Monaco, Monaco.
Sham, service gestion des risques, 69008 Lyon, France.
J Gynecol Obstet Biol Reprod (Paris). 2016 Jan;45(1):54-61. doi: 10.1016/j.jgyn.2015.02.017. Epub 2015 Apr 8.
The aim of this study was to analyze the medicolegal claims related to obstetrics in French hospitals.
We did retrospective study on insurance claims provided by Sham insurances and which has been settled by a court over a 3-year period (2004-2006).
We analyzed 66 closed claims that occurred between 1983 and 2005 in French hospitals (54 general hospitals and 12 academic). The average time between the declaration of the claim and the court conviction was 6 years. The average amount of compensation per claim was 500,000 €. The damage occurred during vaginal delivery (n=44), planned (n=5) or unplanned (n=4) cesarean. The more often claims are fetal asphyxia (n=24) or shoulder dystocia (n=8). The consequences are very important: cerebral palsy (16), death of the newborn (12), death of the mother (2) or brachial plexus injuries (6).
The causes identified by the expert are always multifactorial with generally a misdiagnosis (n=27), a decision making error (n=36), a care error by the midwife (n=21) and/or a delay in medical care (n=13). These data should help strengthen the quality approach in obstetrics.
本研究旨在分析法国医院中与产科相关的法医学索赔。
我们对Sham保险公司提供的、在3年期间（2004 - 2006年）已由法院审结的保险索赔进行了回顾性研究。
我们分析了1983年至2005年期间在法国医院发生的66起已结案索赔（54家综合医院和12家学术医院）。索赔申报至法院定罪的平均时间为6年。每项索赔的平均赔偿金额为50万欧元。损害发生在阴道分娩期间（n = 44）、计划剖宫产（n = 5）或非计划剖宫产（n = 4）。索赔最常见的原因是胎儿窒息（n = 24）或肩难产（n = 8）。后果非常严重：脑瘫（16例）、新生儿死亡（12例）、母亲死亡（2例）或臂丛神经损伤（6例）。
专家确定的原因总是多因素的，通常包括误诊（n = 27）、决策失误（n = 36）、助产士护理失误（n = 21）和/或医疗护理延误（n = 13）。这些数据应有助于加强产科的质量控制措施。
