Introduction: Complaints against physicians have increased in recent years and one of the specialties facing a relatively high rate of complaints is emergency medicine. Therefore, the present study was designed with the aim of evaluating the frequency and causes of complaints against emergency medicine specialists in forensic medicine cases.
Methods: In the present cross-sectional study, all the existing files in two forensic medicine centers, Tehran, Iran, from 2012 to 2015, in which complaints were filed against emergency medicine specialists, either alone or along with other physicians, were evaluated via census sampling method and their required data were extracted and recorded via a pre-designed checklist.
Results: 151 cases of medical complaints were filed against emergency medicine specialists during the study period. 85 (53.6%) complaints were filed following death of the patients and 66 (43.7%) were filed following an injury or disability. Multiple trauma, stomach ache, and altered level of consciousness were the most common chief complaints among young and old patients upon their ED visit. In 104 (68.9%) cases, the emergency medicine specialists were finally proved innocent. No significant correlation was found between the probability of proving innocent and the physician’s experience (p = 0.92), physician’s sex (p = 0.27), age range of the patient (p = 0.193), or the shift in which the patient had visited the ED (p = 0.32). The rate of proving innocent was significantly higher in complaints against governmental hospitals compared to non-governmental ones (73.6% vs. 61.9%; p= 0.004) and teaching hospitals compared to non-teaching ones (75.8% vs. 54.9%; p = 0.26).
Conclusion: In about 70% of medical complaint cases against emergency medicine specialists, the in charge physician was proved innocent. No significant correlation was found between the probability of proving innocent and physician’s experience, the physician’s sex, the patient’s age range, or the shift in which the patient had presented to the ED.
Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. New England Journal of Medicine. 2011;365(7):629-36.
Carrier ER, Reschovsky JD, Mello MM, Mayrell RC, Katz D. Physicians’ fears of malpractice lawsuits are not assuaged by tort reforms. Health affairs. 2010;29(9):1585-92.
Croskerry P, Sinclair D. Emergency medicine: a practice prone to error? Canadian Journal of Emergency Medicine. 2001;3(4):271-6.
Hwang C-Y, Wu C-H, Cheng F-C, Yen Y-L, Wu K-H. A 12-year analysis of closed medical malpractice claims of the Taiwan civil court: A retrospective study. Medicine. 2018;97(13):e0237-e.
Chandra A, Nundy S, Seabury SA. The Growth Of Physician Medical Malpractice Payments: Evidence From The National Practitioner Data Bank: The growth of malpractice payments is less than previously thought. Health Affairs. 2005;24(Suppl1):W5-240-W5-9.
Studdert DM, Mello MM, Gawande AA, Gandhi TK, Kachalia A, Yoon C, et al. Claims, errors, and compensation payments in medical malpractice litigation. New England journal of medicine. 2006;354(19):2024-33.
Bishop TF, Federman AD, Keyhani S. Physicians’ views on defensive medicine: a national survey. Archives of Internal Medicine. 2010;170(12):1081-3.
Mello MM, Chandra A, Gawande AA, Studdert DM. National costs of the medical liability system. Health affairs. 2010;29(9):1569-77.
Carlson JN, Foster KM, Pines JM, Corbit CK, Ward MJ, Hydari MZ, et al. Provider and Practice Factors Associated With Emergency Physicians’ Being Named in a Malpractice Claim. Annals of emergency medicine. 2018;71(2):157-64. e4.
Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients' and physicians' attitudes regarding the disclosure of medical errors. Jama. 2003;289(8):1001-7.
Cosby KS. A framework for classifying factors that contribute to error in the emergency department. Annals of emergency medicine. 2003;42(6):815-23.
Gaynor M, Seider H, Vogt WB. The volume-outcome effect, scale economies, and learning-by-doing. American Economic Review. 2005;95(2):243-7.
Neale FR, Eastman KL, Peterson Drake P. Dynamics of the market for medical malpractice insurance. Journal of Risk and Insurance. 2009;76(1):221-47.
Toth F. Sovereigns under Siege. How the medical profession is changing in Italy. Social Science & Medicine. 2015;136:128-34.
Buzzacchi L, Scellato G, Ughetto E. Frequency of medical malpractice claims: The effects of volumes and specialties. Social Science & Medicine. 2016;170:152-60.
Schaffer AC, Jena AB, Seabury SA, Singh H, Chalasani V, Kachalia A. Rates and characteristics of paid malpractice claims among us physicians by specialty, 1992-2014. JAMA Internal Medicine. 2017;177(5):710-8.
Sadr SS, Ghadyani MH, Zadeh B, Asghar A. Assessment of records of complaints from medical malpractice in the field of orthopedic, in the coroner’s Office of Forensic Medicine, province of Tehran, during 1988 to 2003. IJFM. 2007;13(2):78-86.
Bayazidi S, Zarezadeh Y, Zamanzadeh V, Parvan K. Medication error reporting rate and its barriers and facilitators among nurses. Journal of caring sciences. 2012;1(4):231.
Asadi P, Modirian E, Dadashpour N. Medical Errors in Emergency Department; a Letter to Editor. 2018. 2018;6(1):e33.
Gupta A, Snyder A, Kachalia A, Flanders S, Saint S, Chopra V. Malpractice claims related to diagnostic errors in the hospital. BMJ Quality & Safety. 2018;27(1):53-60.
Schiff GD, Kim S, Abrams R, Cosby K, Lambert B, Elstein AS, et al. Diagnosing diagnosis errors: lessons from a multi-institutional collaborative project. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY ROCKVILLE MD; 2005.