SURGICAL MALPRACTICE LITIGATIONS ARE INEVITABLE OR PREVENTABLE? A QUESTIONNAIRE-BASED STUDY IN EGYPT.

Document Type : Original Article

Authors

1 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

2 Forensic Medicine Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Egypt.

3 Community Medicine Department, Faculty of Medicine, Alexandria University, Egypt.

4 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Egypt.

Abstract

Background: Surgical malpractice in Egypt is one of the leading causes of raising legal claims against physicians, particularly if it results in death.
Objectives: This study investigated in-depth surgical malpractice among Egyptian physicians.
Methodology: an online questionnaire was formulated consistent with literature discussing medicolegal aspects of malpractice in surgery.
Results: Responses were received from 124 physicians in ten Egyptian governorates. 75% of participants were males, and a majority (80.6%) were aged less than 40 years. 73.4% of respondents practiced medicine for 15 years or less, 41% were consultants, and 67.7% had master's and doctorate degrees. The respondents’ scores regarding knowledge of four malpractice pillars were unsatisfactory (mean =1.52 ±0.79), and only 4.7% of the respondents identified all pillars. Nearly two-thirds of participants committed an error during surgical practice. Almost all participants disclosed the error to their patients. 18.5% of participants reported previous malpractice charges, and 9.7% had been convicted of medical malpractice. 58.3% of sentenced participants were between 40 and 50 years and held a master's or doctorate. Three-quarters of convicted participants practiced medicine for 15 years or less. Consultants represented half of the convicted participants of malpractice. The commonest identified error by participants was operating in a poorly equipped medical facility (60.5%), whereas the commonest identified risk factor was defective medical supplies (66.1%). Death and permanent infirmity were the most mentioned outcomes of errors motivated raising malpractice claims (62.1% and 54%, respectively). 75.8% of the respondents noticed increasing surgical malpractice claims in Egypt. 70.2% of the participants reported that getting compensation was the commonest cause of increased claims. Proper medical recording and increasing awareness of medicolegal issues were the most common solutions recommended by 57.3% and 51.6%, respectively.
Conclusion: Egyptian physicians involved in invasive procedures risk being accused and charged with malpractice claims. Masters or doctorate degrees holders with clinical practice for 15 years or less were at higher risk of being charged or even convicted of malpractice than others. It is mandatory to increase awareness of healthcare providers engaged in invasive procedures regarding medicolegal issues, including malpractice pillars.

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