Factors Associated with Medico-Legal Events Resulting from Attempted Suicide by Patients in Care: Facteurs associés aux événements médico-légaux résultant de tentatives de suicide de patients en soins.

ObjectivesThis study provides an overview of the key medico-legal issues associated with attempted or completed suicide in Canada. Specifically, we identify factors that were criticized and found to contribute to medico-legal risk in these cases.MethodsA national repository was retrospectively searched for cases involving patients who attempted or completed suicide while under the care of a physician. The study included cases closed at the Canadian Medical Protective Association between 2013 and 2023. The study involved in- and outpatients who attempted or completed suicide. The frequencies and proportions of patient safety events and medico-legal risks for physicians were calculated by exploring factors that contributed to each incident.ResultsA total of 378 cases were identified, involving 460 physicians. The majority of patients in these cases experienced a healthcare-related harm (224/378, 59%). Psychiatrists were involved in 61% (231/378) of cases. The most common reasons for patient/family complaints were deficient assessments, diagnostic errors, and communication breakdowns with the patient or their family. The most common contributing factors identified by peer experts were deficient assessments of a suicidal patient and inadequate documentation.ConclusionsThis study addressed the gap in the published literature of healthcare-related contributing risk factors associated with a patient safety incident from Canadian medico-legal cases. The most common omissions identified by peer experts were comprehensive assessment and clear documentation. Physicians treating suicidal patients may reduce their medico-legal risk by completing and documenting thorough and timely suicide risk assessments.