@2024 Afarand., IRAN
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(4):177-184
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(4):177-184
Medical Malpractice of Obstetricians and Gynecologists in the Complaint Records Referred to the Forensic Medicine Commission of Tehran Province during 2015-2017
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Rezaie M. (1)Gharibreza M.H. (*1)
Charkh-Abi A. (2)
(1) Forensic Medicine Department, Medicine School, Tehran University of Medical Sciences, Tehran, Iran
(2) Health Department, Ahvaz University of Medical Sciences, Ahvaz, Iran
Correspondence
Address: Forensic Medicine Department, Medical School, Tehran University of Medical Sciences, Poorsina Street, 16 Azar Street, Tehran, Iran. Postal code: 1417414418.Phone: +98 (21) 66348556
Fax: +98 (21) 66348556
dr.gharibreza@gmail.com
Article History
Received: July 7, 2018Accepted: November 26, 2019
ePublished: December 21, 2019
BRIEF TEXT
Obstetricians and gynecologists are at the top of medical malpractice complaints. Medical malpractice in this regard can lead to consequences such as neonatal and fetal deaths, maternal defects, maternal deaths and neonatal defects.
According to studies, the most important reasons for malpractice of obstetricians from patients’ views are absence of physician during night shift, absence of physician on the patient's bedside on time, absence of custodian in hospital, therapeutic error, no attention to financial problems that have sometimes been associated with severe consequences, such as neonatal and fetal death, maternal defects and neonatal defects [8, 9]. … [10, 11]. In Iran, Forensic Medicine is one of the most important organizations to evaluate medical malpractice [12], which also is responsible for medical malpractice of obstetricians.
The aim of this study was to investigate the medical malpractice of obstetricians and gynecologists in the complaint records referred to the forensic medicine commission of Tehran Province during 2015-2017.
This research was a descriptive-analytical cross-sectional study.
This study was conducted on 366 complaint files of obstetricians and gynecologists who were referred to the Forensic Medicine Commission of Tehran Province during 2015-2017.
All cases referred to the Forensic Medicine Organization of Tehran (366 cases) were selected by census method and according to the research population.
A checklist was designed using 19 questions, including open-ended questions (such as age) and closed-ended (multiple choice) questions, which included seven domains. In the present study, medical malpractice by obstetricians and gynecologists and its associated factors were measured and the studied outcome was consequences of the complaint (verdict). Data were analyzed using SPSS 22 software and chi-square test.
The total number of cases was 366, mostly female patients (87.2%) with mean age 19.7 ±18.9 years. Complaint cases ranged from zero (fetal death cases) up to 69 years. The frequency of cases with high school or diploma (21.9%) was higher than other groups. Physicians aged 40-60 were more complained than other age groups, and the majority of physicians were women (90.7%). The highest percentage of complaints was recorded for physicians who were under 20 years of age (77.2%). Physicians who were faculty members had fewer complaints than other physicians. Of the physicians who were not faculty members, most complaints were related to the specialists. There was no significant relationship between demographic variables related to physicians' characteristics and type of medical malpractice based on the expert’ views and type of injury leading to the complaint (Table 1).There was also no significant relationship between demographic variables related to physicians' characteristics and the outcome of a complaint, including acquittal or conviction (Table 2). In 6 studied cases, no verdict had yet been issued and the outcome of the complaint was unclear.Regarding variables related to treatment, there was a significant relationship only between the place of treatment and the type of medical malpractice based on the experts’ views about the case and other variables were not significantly correlated with the type of medical malpractice and injury leading to the complaint (Table 3).
… [13]. In Rafizadeh Tabaei Zavareh et al. study, of 60 malpractice cases, the most cases were related to unskilled physicians (36 cases, 60%), followed by negligence (16 cases, 26.7%). In this study, non-proficiency included lack of skills and efficacy or sufficient information and knowledge to diagnose, treat, surgery, inject or work with various medical devices. In the present study, the most common causes of complaints were the side effects of treatment, followed by patient and fetal deaths. In a study by Adibzadeh et al., 43.7% of complaint cases were due to death and 56.3% due to complications and defects [14]. … [15-17].
It is suggested that more extensive monitoring of the activities of gynecologists be undertaken to improve patient satisfaction and respect their rights, especially during the residency training and training of the specialists.
Complaints appear to be made only by patients who have been seriously injured or have complain about the services provided.
The most common cause of gynecological medical malpractice is negligence. There was no relationship between demographic characteristics of physicians, including age, sex, degree, and work experience with the type of medical malpractice with respect to the forensic results and the type of injury to the patient.
The authors are thankful to the forensic medicine organization for the implementation of this study.
None.
This study was extracted from a thesis in medical assistance (ID: 9411223004) approved by the Ethics Committee of Tehran University of Medical Sciences (274835).
This study was extracted from a thesis in medical assistance.
TABLES and CHARTS
Show attach fileCITIATION LINKS
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[3]Selbst SM, Friedman MJ, Singh SB. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005;21(3):165-9.
[4]Cottam D. Medical malpractice in the twenty-first century. In: Herron DM, editor. Bariatric surgery complications and emergencies. New YorK: Springer; 2016. p. 319-22.
[5]Khoshhal M, Vafaei F, Khoshhal M. Rules governing the liability of dentists in Iran. Iran J Forensic Med. 2013;19(4 and 1):227-32. [Persian]
[6]Tadayon M, Kamyab F, Afshari P, Keikhahi B, Vahabi Shekarloo T, Haghighizadeh MH. Malpractice claims against gynecology and midwifery staff in medical council and forensic centre in khosezstan province and related factors, 2006-2012. J Mazandaran Univ Med Sci. 2016;25(132):320-3. [Persian]
[7]Haghshenas MR, Vahidshahi K, Ahmadzadeh Amiri A, Sheikh Rezaei M, Rahmani N, Pourhossein M, et al. Study the frequency of malpractice lawsuits referred to forensic medicine department and medical council, Sari, 2006-2011. J Mazandaran Univ Med Sci. 2012;21(86):253-60. [Persian]
[8]Akhlaghi M, Tofighi Zavare H, Samadi F. The Sues of gynecoobstetrics referred to the commission of national legal medicine center at 2001-2002; reasons and methods of prevention from these. Iran J Forensic Med. 2004;10(34):70-4. [Persian]
[9]Nocon JJ, Coolman DA. Perinatal malpractice. Risks and prevention. J Reprod Med. 1987;32(2):83-90.
[10]Bagherian Mahmoodabadi H, Setareh M, Nejadnick M, Niknamian M, Ayoobian A. The frequency and reasons of medical errors in cases referred to isfahan legal medicine center. Health Info Manag. 2012;9(1):101-9. [Persian]
[11]Foruzesh M, Ghorbani A, Vosugh M, Mohammadi J. Survey on medical errors in Zanjan from 2005 to 2009. In: Proceedings of the 3rd International Congress of Patient Rights; 2011 Feb 22-24; Kish Convention CentreKish, Hormozgan Province, Iran. Tehran: Shahid Beheshti University of Medical Sciences. Medical Ethics and Law Research Center; 2011. [Persian]
[12]Safdari R, Masoori N, Ghadyani M, Shokrizadeh Arani L. Importance of a proprietary electronic registration system for referral complaints due to medical malpractice in the Forensic Medicine Organization. Iran J Forensic Med. 2005;11(2):99-106. [Persian]
[13]Bagherian Mahmoodabadi H, Lohrasbi F, Setareh M, Lotfi M. Frequency and reasons of midwives malpractices in cases referred to general office of legal medicine of Isfahan, Iran during 2005-2009. Iran J Obstet Gynecol Infertil. 2014;17(99):13-20. [Persian]
[14]Adibzadeh A, Ghadi Pasha M, Pour Amiri A, Nakhaei N, Samadi Rad B, Bastani M. A study on medical malpractices ending to death and disability referred to Kerman Medical council’s medical malpractices commission. Med Law J. 2012;6(20):141-54. [Persian]
[15]Rafizadeh Tabaei Zavareh SM, Hajmanoochehri R, Nassaji Zavareh M. Frequency of malpractice of general practitioners in complaints referred to center of forensic medicine of Tehran from 2003 to 2005. Iran J Forensic Med. 2007;13(3):152-7. [Persian]
[16]Taragin MI, Willett LR, Wilczek AP, Trout R, Carson JL. The influence of standard of care and severity of injury on the resolution of medical malpractice claims. Ann Intern Med. 1992;117(9):780-4.
[17]Localio AR, Lawthers AG, Brennan TA, Laird NM, Hebert LE, Peterson LM, et al. Relation between malpractice claims and adverse events due to negligence: results of the Harvard Medical Practice Study III. N Engl J Med. 1991;325(4):245-51.
[2]Ayoubian A, Mahmoodabadi HB, Dehaghi ZH. Midwifery errors: a descriptive study in Isfahan forensic medicine general department. Mater Sociomed. 2013;25(3):175-7.
[3]Selbst SM, Friedman MJ, Singh SB. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005;21(3):165-9.
[4]Cottam D. Medical malpractice in the twenty-first century. In: Herron DM, editor. Bariatric surgery complications and emergencies. New YorK: Springer; 2016. p. 319-22.
[5]Khoshhal M, Vafaei F, Khoshhal M. Rules governing the liability of dentists in Iran. Iran J Forensic Med. 2013;19(4 and 1):227-32. [Persian]
[6]Tadayon M, Kamyab F, Afshari P, Keikhahi B, Vahabi Shekarloo T, Haghighizadeh MH. Malpractice claims against gynecology and midwifery staff in medical council and forensic centre in khosezstan province and related factors, 2006-2012. J Mazandaran Univ Med Sci. 2016;25(132):320-3. [Persian]
[7]Haghshenas MR, Vahidshahi K, Ahmadzadeh Amiri A, Sheikh Rezaei M, Rahmani N, Pourhossein M, et al. Study the frequency of malpractice lawsuits referred to forensic medicine department and medical council, Sari, 2006-2011. J Mazandaran Univ Med Sci. 2012;21(86):253-60. [Persian]
[8]Akhlaghi M, Tofighi Zavare H, Samadi F. The Sues of gynecoobstetrics referred to the commission of national legal medicine center at 2001-2002; reasons and methods of prevention from these. Iran J Forensic Med. 2004;10(34):70-4. [Persian]
[9]Nocon JJ, Coolman DA. Perinatal malpractice. Risks and prevention. J Reprod Med. 1987;32(2):83-90.
[10]Bagherian Mahmoodabadi H, Setareh M, Nejadnick M, Niknamian M, Ayoobian A. The frequency and reasons of medical errors in cases referred to isfahan legal medicine center. Health Info Manag. 2012;9(1):101-9. [Persian]
[11]Foruzesh M, Ghorbani A, Vosugh M, Mohammadi J. Survey on medical errors in Zanjan from 2005 to 2009. In: Proceedings of the 3rd International Congress of Patient Rights; 2011 Feb 22-24; Kish Convention CentreKish, Hormozgan Province, Iran. Tehran: Shahid Beheshti University of Medical Sciences. Medical Ethics and Law Research Center; 2011. [Persian]
[12]Safdari R, Masoori N, Ghadyani M, Shokrizadeh Arani L. Importance of a proprietary electronic registration system for referral complaints due to medical malpractice in the Forensic Medicine Organization. Iran J Forensic Med. 2005;11(2):99-106. [Persian]
[13]Bagherian Mahmoodabadi H, Lohrasbi F, Setareh M, Lotfi M. Frequency and reasons of midwives malpractices in cases referred to general office of legal medicine of Isfahan, Iran during 2005-2009. Iran J Obstet Gynecol Infertil. 2014;17(99):13-20. [Persian]
[14]Adibzadeh A, Ghadi Pasha M, Pour Amiri A, Nakhaei N, Samadi Rad B, Bastani M. A study on medical malpractices ending to death and disability referred to Kerman Medical council’s medical malpractices commission. Med Law J. 2012;6(20):141-54. [Persian]
[15]Rafizadeh Tabaei Zavareh SM, Hajmanoochehri R, Nassaji Zavareh M. Frequency of malpractice of general practitioners in complaints referred to center of forensic medicine of Tehran from 2003 to 2005. Iran J Forensic Med. 2007;13(3):152-7. [Persian]
[16]Taragin MI, Willett LR, Wilczek AP, Trout R, Carson JL. The influence of standard of care and severity of injury on the resolution of medical malpractice claims. Ann Intern Med. 1992;117(9):780-4.
[17]Localio AR, Lawthers AG, Brennan TA, Laird NM, Hebert LE, Peterson LM, et al. Relation between malpractice claims and adverse events due to negligence: results of the Harvard Medical Practice Study III. N Engl J Med. 1991;325(4):245-51.