Análisis de reclamaciones judiciales contra obstetras y ginecólogos en España. Estudio específico de la vía penal (1987-2013)

  1. Nicolás García-Ruiz 1
  2. Andrés Santiago-Sáez 2
  3. María Elena Albarrán-Juan 3
  4. Elena Labajo-González 3
  5. Bernardo Perea-Pérez 3
  1. 1 Hospital El Escorial de Madrid
    info

    Hospital El Escorial de Madrid

    San Lorenzo del Escorial, España

  2. 2 Hospital Clínico San Carlos de Madrid
    info

    Hospital Clínico San Carlos de Madrid

    Madrid, España

    ROR https://ror.org/04d0ybj29

  3. 3 Universidad Complutense de Madrid
    info

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

Journal:
Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

ISSN: 0377-4732

Year of publication: 2016

Volume: 42

Issue: 4

Pages: 136-141

Type: Article

DOI: 10.1016/J.REML.2016.07.004 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

Sustainable development goals

Abstract

Introduction Court claims against gynaecologists in the Spanish criminal court system are a rare occurrence (less than 3%). These can lead to financial penalties, imprisonment and disqualification. Our aim is to study the court sentences issued in such cases, as these involve the most serious convictions, and to obtain a profile of those convicted. Material and methods A retrospective analysis of the sentences against gynaecologists during the period from 1987 to 2013. We used F-distribution tables, normal distribution tables and Student's t-test to compare differences between groups, and the Mann-Whitney nonparametric test for comparison of independent samples. In order to define two broad groups, those of “convicted” and “not convicted,” we performed a multivariate study analysis followed by cluster analysis to determine similar sentences. Results Of the 85 cases, 56.4% of complaints came from procedures in the public sector, but the highest rate of convictions (59.3%) was based on complaints originating in the private healthcare sector. The likelihood of conviction in events related to childbirth was 36.6% (20 out of 55) versus 16.6% (5 out of 30) in incidents of another origin. 69.2% of cases of criminal proceedings for permanent neurological damage (neonatal encephalopathy) concluded in a criminal conviction and had the highest financial compensation. The average time elapsed between the incident and the sentence was 5.7 years. With a prior conviction, the possibility of confirmation at higher levels was 71.9%. An acquittal was confirmed in 96.2% of cases. Conclusions Of the court claims filed against gynaecologists based on their professional activity, very few are decided upon in the criminal courts. Most are due to complications during childbirth, and one-third ends with a conviction. A judgment of acquittal is most likely to be confirmed when this was the case with the previous one.

Bibliographic References

  • 1. OB/GYN Rates and Risk of Malpractice: Considerations for the University of Connecticut Health Center Cre- dentialing Committee; 2009. UCHC Graduate School Masters Theses 2003-----2010. Paper 158. Available in: http://digitalcommons.uconn.edu/uchcgs masters/158 [accessed 23.06.13].
  • 2. Gómez-Duran EL, Lailla-Vicens JA, Benet-Travé J, Arimany- Manso J. Analysis of obstetrics and gynecology professional liability claims in Catalonia, Spain (1986-----2010). J Forensic Leg Med. 2009;16:301-----6.
  • 3. Las reclamaciones a médicos se duplican [Website]. Madrid: Uniteco Profesional Correduría de Seguros. Available in: http:// www.unitecoprofesional.es/blog/wp-content/uploads/2012/ 05/230512 Las-reclamaciones-a-m%C3%A9dicos-se-duplican- VOK.pdf [accessed 18.11.14].
  • 4. Pérez Pérez B, Santiago Saez A, Labajo González ME, Albar- rán Juan MI, Sánchez Sánchez JA. Análisis de las consecuencias médico-legales de las reclamaciones judiciales de pacientes. Estudio comparativo de los casos de traumatología, ginecología y obstetricia, anestesia y reanimación, y odontoestomaología. Trauma Fund Mapfre. 2009;20:264-----8.
  • 5. Arimany-Manso J, Gómez-Durán EL, Aubia-Marimon J. Las reclamaciones sobre responsabilidad profesional por especiali- dades en un escenario diferente al estadounidense. Gac Sanit. 2013;27:89-----93.
  • 6. aos.org [Website]. Worldwide trends in medical liabil- ity. Rosemont, Illinois: American Academy of Orthopaedic Surgeons. Available in: http://www.aaos.org/news/ aaosnow/sep11/managing4.asp [accessed 30.02.14].
  • 7. Llamas Pombo E. La responsabilidad civil del médico. Aspectos tradicionales y modernos. Madrid: Trivium; 1988.
  • 8. Jena AB, Seabury S, Lakdawalla D, Chandra A. Malprac- tice risk according to physician specialty. N Engl J Med. 2011;365:629-----36.
  • 9. Committee on Professional Liability. Coping with the stress of malpractice litigation: number 150 --- December 1994. Int J Gynaecol Obstet. 1995;49:83-----4.
  • 10. Xu X, Siefert KA, Jacobson PD, Lori JR, Ransom SB. The effects of medical liability on obstetric care supply in Michigan. Am J Obstet Gynecol. 2008;198:1-----9.
  • 11. Yang YT, Mello MM, Subramanian SV, Studdert DM. Relationship between malpractice litigation pressure and rates of cae- sarean section and vaginal birth after caesarean section. Obstet Gynecol. 1991;78:1050-------4.
  • 12. Schifrin BS, Cohen WR. The effect of malpractice claims on the use of caesarean section. Best Pract Res Clin Obstet Gynaecol. 2013;27:269---83.
  • 13. Mello MM, Studdert DM, Brennan TA. The new medical malprac- tice crisis. N Engl J Med. 2003;348:2281---4.
  • 14. Sánchez García MM. La responsabilidad médica y los dere- chos del paciente. In: Sociedad Espan˜ola de Obstetricia y Ginecología, editor. Problemas Jurídicos en Obstetricia y Gine- cología. Madrid. 2013. p. 5---23.
  • 15. De Lorenzo O. La responsabilidad penal de los especialistas en obstetricia y ginecología. In: Sociedad Espan˜ola de Obstetri- cia y Ginecología, editor. Aspectos jurídicos en Obstetricia y Ginecología. Madrid. 2008. p. 251---87.
  • 16. Le risque des professions de santé en 2006 [Website]. Decisions de justice. Rapport sur les décisions de justice rendues en 2006 (médecins sociétaires du Sou Médical --- Groupe MACSF). Respon- sabilité, Revue de formation sur le risque médical. Available in: http://www.cfef.org/archives/bricabrac/macsf2006.pdf [accessed 07.02.14].
  • 17. Johnson SL, Blair E, Stanley FJ. Obstetric malpractice litiga- tion and cerebral palsy in term infants. J Forensic Leg Med. 2011;8:97---100.
  • 18. Jonsson M, Agren J, Nordén-Lindeberg S, Ohlin A, Han- son U. Neonatal encephalopathy and the association to asphyxia in labor. Am J Obstet Gynecol. 2014;211:667e1-- 8.
  • 19. Arimany-Manso J, Gómez-Durán EL, Barbería-Marcalain E, Benet-Travé J, Martin-Fumadó C. Catastrophic medical mal- practice payouts in Spain. J Healthc Qual. 2015 [Electronic publishing].
  • 20. Bixenstine PJ, Shore AD, Mehtsun WT, Ibrahim AM, Freischlag JA, Makary MA. Catastrophic medical malpractice payouts in the United States. J Healthc Qual. 2014;36:43---53.
  • 21. derecho.publicacionmedica.com [Website]. Asociación Espan˜ola de Derecho Sanitario. Available in: http://derecho. publicacionmedica.com/noticia/solo-el-5-de-las-demandas- penales-contra-los-medicos-llegan-a-la-fase-de-enjuiciamiento [Updated June 2016, accessed 03.05.15].