Evaluation of medical errors in obstetrics and gynecology wards: A Descriptive cross-sectional study between 2002 and 2018 in Jahrom city

Document Type : Research Paper

Authors

1 Forensic Medicine Research Center, Forensic Medicine Organization, Tehran, Iran.

2 Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.

3 MD, Iranian legal Medicine Research Center, legal Medicine Organization, Tehran, Iran

4 Clinical Research Development Unit (CRDU), Peymanieh Hospital, Jahrom University of Medical Sciences, Jahrom, Iran

5 Women’s Health and Disease Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.

Abstract

Abstract:
Introduction:
Medical malpractice is an act committed by a medical or healthcare professional who deviates from the standards in his or her profession and causes harm to the patient. Meanwhile, medical malpractice in the field of obstetrics and gynecology includes a wide range of complaints against physicians, and prevention of this type of malpractice requires an understanding of its epidemiology. In this study, medical errors in gynecology and obstetrics departments of Jahrom city were investigated.
Method:
A cross-sectional-descriptive study was conducted to investigate medical errors related to referral cases to Jahrom Forensic Medicine Organization in the gynecology and obstetrics departments between 2002 and 2018. The method of data collection was based on the questionnaire and the use of the information in the files in the medical commission of the General Directorate of Forensic Medicine of Jahrom city. The data were analyzed in SPSS software.
Results:
Sixteen complaints have been lodged against Obstetrician and gynecologist specialists in the evaluated period; Of the 14 cases (82.35%) related to childbirth, 1 case (5.88%) was related to genital infection and 1 case (5.88%) was related to breast tumor. The average age of the plaintiffs was 29.81. The youngest complainant was 24 years old and the oldest was 45 years old. Votes issued for 9 cases (52.94%) of complaints leading to failure to prove negligence, 3 cases (17.64%) indicating negligence of obstetrician and gynecologist, 2 cases (11.76%) of the ban on prosecution due to the time, 1 case (5.88%) resulted in a written cautation to gynecologist and 1 case (5.88%) resulted in the plaintiff's consent to the obstetrician. There were three cases of negligence, one involving the placement of surgical instruments during a cesarean section, one involving the death of a baby during childbirth, and one involving the absence of a diagnosis of a breast tumor.
Conclusion:
Most of the medical malpractice charges in cases against obstetricians and gynecologists are related to labor management. This demonstrates the need to provide courses based on complex cases leading to complaints for the obstetrics and gynecology department.

Keywords


1. Ubaldus de Vries, “Professional Negligence
Reconsidered” (PhD Thesis, Dublin City
University Business School, Republic of Ireland,
1996) p153.
2. Marcus, Paul (1981). "Book Review of Medical
Malpractice Law: A Comparative Law Study of
Civil Responsibility Arising from Medical Care".
Hastings International and Comparative Law
Review: 235–243. Retrieved 12 June 2017.
3. Schifrin BS, Cohen WR. The effect of malpractice
claims on the use of caesarean section. Best
Practice & Research Clinical Obstetrics &
Gynaecology. 2013;27(2):269-283.
4. New Islamic Penal Code - Note to 336
5. Brock, Douglas M.; Nicholson, Jeffrey G.;
Hooker, Roderick S. (2016). "Physician Assistant
and Nurse Practitioner Malpractice Trends".
Medical Care Research and Review. PMID
27457425. Retrieved 31 January 2018.
6. "Medical Liability". National Conference of State
Legislatures. 13 January 2014. Retrieved 23
November 2017.
7. "NPDB Research Statistics". National Practitioner
Data Bank. U.S. Health Services & Resources
Administration. Retrieved 23 November 2017.
8. Oliphant, Ken; Wright, Richard W. (2013).
Medical Malpractice and Compensation in Global
Perspective. Walter de Gruyter. ISBN
3110270234.
9. Larson, Aaron (8 November 2014). "Medical
Malpractice Law". ExpertLaw.com. Retrieved 13
December 2017.
10. National Conference of State Legislatures.
Medical malpractice reform. Health Cost
Containment and Efficiencies NCSL, Briefs for
State Legislators. Vol 16 October 2011; 71-74.
Available at:
http://www.ncsl.org/documents/health/IntroandBr
iefsCC-16.pdf. Accessed July 2015.
11. Araban, M, Karimy M, Tavousi M, Shamsi M,
Niakan Kalhori SH, Khazaiyan, S, etal. Quality of
Midwifery Care Provided to Women
Admitted. Advances in Nursing & Midwifery.
2014; 23(81), 19-26.
12. Ganann R, Ciliska D, Thomas H. Expediting
systematic reviews: methods and implications of
rapid reviews. Implement Sci. 2010;5:56.
13. Kerry J Breen et al., Good Medical Practice:
Professionalism, Ethics & the Law, (Cambridge:
Cambridge University Press, 2010), p105.
14. American College of Obstetricians and
Gynecologists. Professional liability and risk
management: an essential guide for obstetrician –
gynecologists. Washington, DC: ACOG; 2005.
15. Jena AB, Chandra A, Lakdawalla D, Seabury S.
Outcomes of medical malpractice litigation against
US physicians. Archives of internal medicine.
2012 Jun 11;172(11):892-4.
16. Wang Z, Li N, Jiang M, Dear K, Hsieh CR.
Records of medical malpractice litigation. a
potential indicator of health-care quality in China.
2017 Jun;2017:95.
17. Daniels AH, Ruttiman R, Eltorai AE, DePasse JM,
Brea BA, Palumbo MA. Malpractice litigation
following spine surgery. Journal of Neurosurgery:
Spine. 2017 Oct 1;27(4):470-5.
18. Siabani S, Alipour AA, Siabani H, Rezaei M,
Daniali S. A survey of complaints against
physicians reviewed at Kermanshah. Journal of J
Kermanshah Univ Med Sci. 2009;13(1).
19. Gómez-Durán EL, Mulà-Rosías JA, LaillaVicens
JM, Benet-Travé J, Arimany-Manso J. Analysis of
obstetrics and gynecology professional liability
claims in Catalonia, Spain (1986–2010). Journal of
forensic and legal medicine. 2013;20(5):442-6.
20. Cardoso, R., et al., Rapid scoping review of
medical malpractice policies in obstetrics.
Toronto, (ON), Canada, BreaKThrough,
Knowledge Translation Program, Li Ka Shing
Knowledge Institute, St. Michael’s Hospital, 2015.
21. Akhlaghi M, Tofighi H, Samadi F. Medical
malpractice complaints referred to the
Commission in the field of obstetrics and
gynecology forensic LMO 2001-3 years: causes
and ways to prevent it. Iranian Journal of Forensic
Medicine. 2003;10(34):70-4.
22. Beigi M, Asadi L, Valiani M, Mardani F.
Evaluating different types of malpractices in
midwifery that were referred to the forensic
medicine commission and the medical council
between 2006 and 2011 in Isfahan province, 2013.
Iranian journal of nursing and midwifery research.
2015;20(4):426.
23. Edwards, C.T., The Impact of No-Fault Tort
Reform on Physician Decision-Making: A Look at
Virginia's Birth Injury Program. Rev. Jur. UPR,
2011. 80: p. 285
24. Domin S. Where Have All the Baby-Doctors
Gone-Women's Access to Healthcare in Jeopardy:
Obstetrics and the Medical Malpractice Insurance
Crisis. Cath. UL Rev.. 2003;53:499.
25. Berglund, S., et al., Severe asphyxia due to
delivery‐ related malpractice in Sweden 1990–
2005. BJOG: An International Journal of
Obstetrics & Gynaecology, 2008. 115(3): p. 316-
323.
26. Walsh JM, Kandamany N, Shuibhne NN, Power
H, Murphy JF, O'herlihy C. Neonatal brachial
plexus injury: comparison of incidence and
antecedents between 2 decades. American journal of obstetrics and gynecology. 2011 Apr
1;204(4):324-e1.
27. Kamiab F, Afshari P, Keikhahi B, Tadayon M,
Vahabi Shekarloo T, Haghighizadeh M H. A
Review of Reasons of Malpractice of
Obstetricians, Gynecologists and Midwives. Sci J
Forensic Med. 2016; 22 (3):165-171