A 12-year analysis of closed medical malpractice claims of the Taiwan civil court

Abstract

Malpractices lawsuits cause increased physician stress and decreased career satisfaction, which might result in defensive medicine for avoiding litigation. It is, consequently, important to learn experiences from previous malpractice claims. The aim of this study was to examine the epidemiologic factors related to medical malpractice claims, identify specialties at high risk of such claims, and determine clinical which errors tend to lead to medical malpractice lawsuits, by analyzing closed malpractice claims in the civil courts of Taiwan.The current analysis reviewed the verdicts of the Taiwan judicial system from a retrospective study using the population-based databank, focusing on 946 closed medical claims between 2002 and 2013.Among these medical malpractice claims, only 14.1% of the verdicts were against clinicians, with a mean indemnity payment of $83,350. The most common single specialty involved was obstetrics (10.7%), while the surgery group accounted for approximately 40% of the cases. In total, 46.3% of the patients named in the claims had either died or been gravely injured. Compared to the $75,632 indemnity for deceased patients, the mean indemnity payment for plaintiffs with grave outcomes was approximately 4.5 times higher. The diagnosis groups at high risk of malpractice litigation were infectious diseases (7.3%), malignancies (7.2%), and limb fractures (4.9%). A relatively low success rate was found in claims concerning undiagnosed congenital anomalies (4.5%) and infectious diseases (5.8%) group. A surgery dispute was the most frequent argument in civil malpractice claims (38.8%), followed by diagnosis error (19.3%).Clinicians represent 85.9% of the defendants who won their cases, but they spent an average of 4.7 years to reach final adjudication. Increased public education to prevent unrealistic expectations among patients is recommended to decrease frivolous lawsuits. Further investigation to improve the lengthy judicial process is also necessary to relieve the stress of medical malpractice claims on clinicians and practitioners, as well as on the judicial system and rightful claimants.

Retrospective analysis of medical malpractice claims in tertiary hospitals of China: the view from patient safety

“…10 Hwang et al found that in Taiwan, only 14.1% of verdicts in medical malpractice claims identified medical errors. 16 In Poland, a commission analysed adverse medical events and found that 23.7% of claims were due to medical errors. 19 Higher mortality but lower proportionate liability in grade-A tertiary hospitals of China In China, tertiary hospitals receive and treat mainly patients with serious diseases.…”

“…Thus, an analysis of completed lawsuits on medical malpractice claims could help identify priority areas where actions can reduce medical malpractice. 12 Studies of medical liability claims have directed great attention to the following topics: how to reduce medical errors [13][14][15] ; how to avoid medical damage 16 ; how to increase the ability to recognise medical malpractice 17 ; how to continuously improve the quality of medical services 18 and how to achieve satisfactory levels of patient safety. 5 19-21 On the basis of previous research, we concluded that a better understanding is needed of the relationship among adverse health outcomes, medical malpractice and patient safety.…”

Desdobramentos judiciais do erro na enfermagem

“…Lawsuits involving physicians are discussed in the literature and pointed out as one of the causes of stress, decrease of career satisfaction and exercise of defensive medicine to avoid litigious processes. (15) In addition, physicians commonly work autonomously, differentiating themselves from other health professionals who, in general, have institutional support due to the employment relationship.…”

“…However, this type of analysis has been carried out in the medical field in Taiwan, for example, where physicians also work autonomously, the average value in court convictions for medical error was around 83 thousand US dollars. (15) In Brazil, most of the time, the nursing team acts under an employment relationship with a health institution, which denotes the service of joint responsibility, for being responsible for ensuring the quality of the services offered. (4) Thus, it is justified that, from the total of civil convictions, 17 culminated in convictions of the health institution by the practice of nursing professionals, concomitantly with the manifestation of high institutional management in defense of the mistake committed by its professional (58.06%) ( Table 3).…”

Analysis of the High Court Decisions on Informed Consent Cases in Turkey From a Forensic Point of View

“…In medical malpractice cases insufficient and unreliable records are an important argument used by plaintiffs (Altun and Yorulmaz, 2010). For cases related to plastic surgery interventions (Vila-Nova da Silva et al, 2015;Hwang et al 2018), the main factors severely affecting court judgments were stated to be the quality of medical records and informed consent, and photographs from before and after surgery. In this research analyzing high court judgments in Turkey, the majority of interventions were surgical; however, among these there were several plastic surgery interventions and 9 (28.1%) were surgical interventions not requiring general anesthesia and medical interventions with diagnostic and/or treatment purposes.…”