Clear data on the epidemiology of medical malpractice are missing, at least for Germany. According to a review of the German Alliance of Patient Safety, adverse events can be expected in 5–10%, preventable adverse events in 2–4%, negligent adverse events in about 1%, and lethal outcome in about 0.1% of hospitalized patients. However, these data are not compatible with figures from civil and penal law and there seems to be a great “litigation gap”.
Data on malpractice cases are available from the files of the arbitration committees, files of liability insurance companies, and files of the institutes of forensic medicine.
The arbitration committees are, however, mainly dealing with living patients. Lethal cases are a special subgroup and the best available data source are the files of the institutes of forensic medicine. This subgroup is of special importance since death is the most severe outcome of medical malpractice and the reproach to have caused the death of a patient by medical negligence is the most severe malpractice claim.
From a retrospective multicenter study on autopsies performed in cases of medical malpractice claims (altogether 101.358 autopsies, 4450 due to medical malpractice claims), the most important data will be presented. These data are not only of a descriptive value but have utmost importance also for risk analysis and to increase patient safety. Identification and evaluation of errors as well as reporting of errors may also contribute to the prevention of errors, which is among other medical disciplines also a task of forensic medicine