Estudio de las compensaciones económicas sobre sentencias contra obstetras y ginecólogos en España (1987-2013)

  1. Nicolás García-Ruiz
  2. Andrés Santiago-Sáez
  3. María Elena Albarrán-Juan
  4. Elena Labajo-González
  5. Bernardo Perea-Pérez
Zeitschrift:
Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

ISSN: 0377-4732

Datum der Publikation: 2017

Ausgabe: 43

Nummer: 2

Seiten: 64-69

Art: Artikel

DOI: 10.1016/J.REML.2016.11.003 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

Zusammenfassung

Introduction Malpractice payouts occupy an important place in Obstetrics and Gynaecology. We analysed a long period (1987–2013) of court sentences focusing on compensation amount and the way compensation has changed. In Spain there are not many economic analyses on Obstetrics and Gynaecology, specifically on the main adverse events that lead to catastrophic payouts. Material and methods A retrospective analysis of a legal database on court sentences in civil and administrative litigation against obstetricians and gynaecologists during the study period was performed. The adverse event under examination, the year of the ruling, and the payouts for malpractice were the variables analysed. Statistical analysis was performed using SPSS Statistics 19.0, F-distribution and normal distribution tables as well as the Student's t-test to compare differences between groups. Results We recovered 431 cases, 244 of which resulted in a conviction (56.6%). Obstetrics involved the highest payouts (p=0.01) and a 57.5% chance of being convicted. The accusations with the highest payouts involved fetal death or fetal injury, which were the most common cause of payouts exceeding €300,000. Overall, 78.7% (193) of convictions involved a payout below €300,000 and the mean, median and maximum payouts increased steadily during the study period. Conclusions Obstetric claims and fetal-related injury involve the highest payouts, with an increasing trend. Catastrophic payouts are common.

Bibliographische Referenzen

  • P.M. Danzon Liability for medical malpractice A.J. Culyer, J.P. Newhouse (Eds.), Handbook of health economics, North-Holland, Amsterdam (2000), pp. 1339-1404
  • 2 M. Carles Responsabilidad por una práctica médica inadecuada: una perspectiva económica Gac Sanit, 17 (2003), pp. 494-503
  • 3 J.J. Mira, M. Guilabert, I.M. OrtízL. Navarro, M.V. Pérez-Jover, J.M. Aranaz Noticias de prensa sobre errores clínicos y sensación de seguridad al acudir al hospital Gac Sanit, 24 (2010), pp. 33-39
  • 4 J.J. Llovet Las reclamaciones judiciales por mala praxis médica Rev Esp Salud Públ, 67 (1993), pp. 315-323
  • 5 C. Guillen, I. Aguinaga, F. Guillen La medicina basada en la evidencia en el sistema judicial norteamericano An Sist Sanit Navar, 21 (1998), pp. 385-388
  • 6 E.L. Gómez-Duran, J.A. Lailla-Vicens, J. Benet-Travé, J. Arimany- Manso Analysis of obstetrics and gynecology profesional liability claims in Catalonia, Spain (1986–2010) J Forensic Leg Med, 16 (2009), pp. 301-306
  • 7 B. Perea Pérez, A. Santiago Saez, M.E. Labajo González, M.I. Albarrán Juan, J.A. Sánchez Sánchez 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 odontoestomatología Trauma Fund Mafre, 20 (2009), pp. 264-268
  • 8 B. Perea-Pérez, A. Santiago-Saéz, M.E. Labajo-González, M.E. Albarrán-Juan, E. Dorado-Fernández, A. García-Martín El médico ante los tribunales: análisis de las sentencias judiciales relacionadas con la responsabilidad profesional médica en España Rev Esp Med Legal, 39 (2013), pp. 130-134
  • 9 J. Arimany-Manso, E.L. Gómez-Durán, E. Barbería-Marcalain, J. Benet-Travé, C. Martin-Fumadó Catastrophic medical malpractice payouts in Spain J Healthc Qual, 38 (2015), pp. 290-295 Epub ahead of print
  • 10 P.J. Bixenstine, A.D. Shore, W.T. Mehtsun, A.M. Ibrahim, J.A. Freischlag, M.A. Makary Catastrophic medical malpractice payouts in the United States J Healthc Qual, 36 (2014), pp. 43-53
  • 11 A.B. Jena, S. Seabury, D. Lakdawalla, A. Chandra Malpractice risk according to physician specialty N Engl J Med, 365 (2011), pp. 629-636
  • 12 J. Arimany-Manso, E.L. Gómez-Durán, J. Aubia-Marimon Las reclamaciones sobre responsabilidad profesional por especialidades en un escenario diferente al estadounidense Gac Sanit, 27 (2013), pp. 89-93
  • 13 Le risque des professions de santé en 2006 [Internet]. Decisions de justice. Rapport sur les décisions de justicerendues en 2006 (médecins sociétaires du Sou Médical-Groupe MACSF). Responsabilité, Revue de formation sur le risque médical [consulted Nov 2014]. Available in: http://www.cfef.org/archives/bricabrac/macsf2006.pdf
  • 14 Baremo para la determinación de indemnizaciones por daños derivados de actividades en el ámbito sanitario [Internet], Madrid, 28 June 2013 [consulted Dec 2015]. Available in: http://static.diariomedico.com/docs/documentos/baremo.pdf
  • 15 M.M. Chou Litigation in obstetrics: a lesson learnt and a lesson to share Taiwan J Obstet Gynecol, 45 (2006), pp. 1-9
  • 16 J. Adinma Litigations and the obstetrician in clinical practice Ann Med Health Sci Res, 6 (2016), pp. 74-79
  • 17 N. García-Ruiz, A. Santiago-Sáez, M.E. Albarrán-Juan, E. Labajo-González, B. Perea-Pérez Análisis de reclamaciones judiciales contra obstetras y ginecólogos en España. Estudio específico de la vía penal (1987-2013) Rev Esp Med Legal, 42 (2016), pp. 136-141
  • 18 D.G. Williams Practice patterns to decrease the risk of a malpractice suit Clin Obstet Gynecol, 59 (2016), pp. 439-446
  • 19 T. Hamasaki, A. Hagihara A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments BMC Med Ethics, 16 (2015), p. 72
  • 20 B.S. Schifrin, W.R. Cohen The effect of malpractice claims on the use of caesarean section Best Pract Res Clin Obstet Gynaecol, 27 (2013), pp. 269-283
  • 21 A. Boyle, U.M. Reddy Epidemiology of cesarean delivery: the scope of the problem Semin Perinatol, 36 (2012), pp. 308-314
  • 22 C.T. Johnson, V. Choubey, A. Satin, E.F. Werner Malpractice and obstetric practice: the correlation of malpractice premiums to rates of vaginal and cesarean delivery Am J Obstet Gynecol, 214 (2016), pp. 545-546
  • 23 Chandra A, Nundy S, Seabury SA. The growth of physician medical malpractice payments: evidence from the national practitioner data bank. Health Affairs, published online May 31, 2005.
  • 24 D.M. Studdert, M.M. Mello, A.A. Gawande, T.K. Gandhi, A. Kachalia, C. Yoon, et al. Claims, errors, and compensation payments in medical malpractice litigation N Engl J Med, 354 (2006), pp. 2024-2033
  • 25 J. Arimany-Manso, E.L. Gómez-Durán, M. Bruguera, J. Aubia Un modelo integral y de gestión directa del aseguramiento de la responsabilidad profesional médica en Cataluña Med Clin (Barc), 141 (2013), pp. 300-304
  • 26 Arimany-Manso J, Esperanza L. Gómez-Durán Reclamaciones por presunto defecto de praxis [Internet]. Seguridad clínica. 2014 [consulted in 2016]. Available in: https://www.comb.cat/cat/professional/responsabilitat/pdf/2014LlibreSEGURIDADCLINICA.pdf
  • 27 C.J. Ward, V.L. Green Risk management and medico-legal issues in breast cancer Clin Obstet Gynecol, 59 (2016), pp. 439-446
  • 28 A.H. MacLennan A template for defining a causal relation between acute events and cerebral palsy: international consensus statement BMJ, 319 (1999), pp. 1054-1059
  • 29 G.D.V. Hankins, M. Speer Defining the pathogenesis and pathophysiology of neonatal encephalopathy and cerebral palsy Obstet Gynecol, 102 (2003), pp. 628-636
  • 30 A.H. MacLennan, S.C. Thompson, J. Gecz Cerebral palsy: causes, pathways, and the role of genetic variants Am J Obstet Gynecol, 213 (2015), pp. 779-788
  • 31 M. Jonsson, J. Agren, S. Nordén-Lindeberg, A. Ohlin, U. Hanson Neonatal encephalopathy and the association to asphyxia in labor Am J Obstet Gynecol, 211 (2014) 667.e1-8
  • 32 J. Hasegawa, S. Toyokawa, T. Ikenoue, Y. Asano, S. Satoh, T. Ikeda, et al. Relevant obstetric factors for cerebral palsy: from the nationwide obstetric compensation system in Japan PLoS ONE, 11 (2016), p. e0148122
  • 33 S.L. Johnson, E. Blair, F.J. Stanley Obstetric malpractice litigation and cerebral palsy in term infants J Forensic Leg Med, 18 (2011), pp. 97-100
  • 34 P.G. Peters Jr. Twenty years of evidence on the outcomes of malpractice claims Clin Orthop Relat Res, 467 (2009), pp. 352-357
  • 35 M. Castellano Arroyo, S.D. Ferrara La responsabilidad profesional médica en Europa Rev Esp Med Legal, 40 (2014), pp. 161-166
  • 36 P. Soergel, O. Schöffski, P. Hillemanns, U. Hille-Betz, S. Kundu Increasing liability premiums in Obstetrics—analysis, effects and options Geburtshife Frauenheilkd, 75 (2015), pp. 367-376