Objective To study the medical malpractice cases involving death, and discuss the identification ideas and methods of medical malpractice cases. Methods A total of 291 medical malpractice cases involving death accepted and settled from January 2012 to December 2017 at the Judicial Appraisal Center of Southern Medical University were collected. Based on the age, gender, hospital level, clinical department, whether or not autopsy was performed, cause of death, cause of medical mistakes, causality and causative potency of the appraised person, statistical analysis was made. Results There were more males than females in medical malpractice cases involving death. Mostly young adults or children were involved in these cases. The number of cases involving tertiary hospitals was the highest; among the clinical departments, the internal medicine department had the largest number of cases, followed by surgery, obstetrics and gynecology, pediatrics, etc. Autopsy rate has a trend of increasing year by year. Most patients die from the natural outcomes of their disease or ineffective treatment. Most hospitals have certain medical mistakes, and have an indirect correlation with the patient's death, mainly slight factors. Conclusion Judicial appraisal of medical malpractice should follow the principle of "one-effect and multi-cause", and comprehensively consider various factors such as, the diseases and constitution of the patient, natural outcomes of the diseases, the current medical technology and the level of diagnosis and treatment of the hospital, etc.
Autopsy ; Cause of Death ; Child ; Death ; Female ; Hospital Departments/statistics & numerical data* ; Humans ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Pregnancy ; Retrospective Studies ; Young Adult

OBJECTIVES: To synthetically analyse the medical malpractice cases of cardiac death in forensic identification, and to explore the generality and characteristic of cause of death, medical malpractice and assessment of participation degree. METHODS: Totally 52 medical malpractice cases of cardiac death examined in the Xiaoshan Branch Office, Hangzhou Minghao Forensic Judical Appraisal Institute, from January 2015 to April 2018 were collected. The general information of cases, medical institutions and situations of hospital stay, cause of death, medical malpractice and assessment of participation degree were retrospectively analysed. RESULTS: In 52 cases, the male to female ratio was 2.25:1, and most subjects aged >50-60. Cardiac death caused by hypertensive heart disease or coronary heart disease was most common （67.3%）, followed by viral myocarditis and cardiomyopathy （13.5%）. There were 24 cases involved surgery, and the survival time after surgery was from 1 h to 118 d with a 7 d medium value. There were 63 medical institutes involved in these medical malpractices. Medical malpractice presented in most hospitals more or less, and the participation degree was >20%-30%. CONCLUSIONS Forensic appraisal contributes to determine causes of death, which not only provides scientific evidence for medical malpractice identification, but also improves diagnosis and treatment levels of medical institutions.
Autopsy ; Cause of Death ; Coronary Disease/mortality* ; Death ; Female ; Forensic Medicine ; Humans ; Hypertension/mortality* ; Male ; Malpractice/statistics & numerical data* ; Middle Aged ; Retrospective Studies

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

OBJECTIVETo analyze the characteristics of autopsies in medical dispute.

METHODSThe data of 202 autopsy cases in medical disputes performed by the Department of Pathology of Jiangxi Medical College from January 2001 to December 2010 were retrospectively analyzed.

RESULTSThe number of autopsy in medical disputes increased year by year. Neonatal, infant and 30 ≊ 60y were more common age groups in dispute; the gender ratio of male to female was 2:1 and more cases were from hospitals in rural areas. Most medical disputes came from in departments of pediatric, obstetrics and gynecology and general surgery. Death caused by cardiovascular diseases ranked at the first place.

CONCLUSIONAutopsy is important in medical disputes to define the cause of death and to preserve evidence.

Adolescent ; Adult ; Aged ; Autopsy ; statistics & numerical data ; Cardiovascular Diseases ; mortality ; Cause of Death ; Child ; Child, Preschool ; Dissent and Disputes ; Female ; Hospital Departments ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Malpractice ; Middle Aged ; Retrospective Studies ; Sex Ratio ; Young Adult

OBJECTIVE: To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. METHODS: One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. RESULTS: The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). CONCLUSION Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.
Cause of Death ; China ; Diagnostic Errors/statistics & numerical data* ; Expert Testimony/legislation & jurisprudence* ; Female ; Forensic Medicine ; Humans ; Informed Consent ; Intraoperative Complications/mortality* ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Surgical Procedures, Operative

OBJECTIVE: To explore the main reasons of medical malpractice of fetal abnormalities and to analyze the key points and the ideas in judicial appraisal. METHODS: According to the related laws, regulations and clinical practice guidelines, the medical faults and the contribution degree in 12 medical malpractice cases about fetal abnormalities were analyzed. RESULTS: There were medical faults in five cases. Among them, the doctors did not fulfill the duty of inform in 2 cases, did not analyze the abnormal results comprehensively in 2 cases, did not have qualified medical conditions and normative reports in 1 case. The hospitals needed to take the minor responsibility in 2 cases and slight responsibility in 2 cases. CONCLUSION The key points in the judicial appraisal are whether the doctors abide by the related laws, regulations and clinical practice guidelines in prenatal examination, screen and diagnosis, and whether the doctors realize the limitations of ultrasonic testing and fulfill the obligation of inform.
Expert Testimony ; Female ; Fetus/abnormalities* ; Forensic Medicine ; Humans ; Informed Consent ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography, Prenatal

OBJECTIVE: To analyze the causes of medical malpractice in patients with tumor, to determine the medical responsibility, and to recommend the related preventions. METHODS: Seventy four medical malpractice cases, which were involved in tumor and collected from 2000 to 2009 in medicolegal expertise center of west China, were analyzed retrospectively. RESULTS: The medical malpractice cases in the patients with tumor showed an increasing tendency in recent years. The main causes are missed diagnosis, misdiagnosis, improper chemotherapy and neglect of complications. The causes of medical malpractice were different in the different levels of medical services. The occurrence of medical malpractice in surgery and OB-GYN showed more frequent than the others. CONCLUSION Forensic pathology autopsy is important to resolve medical malpractice of tumor patients by finding out the cause of death and clarifying the medical responsibility. The occurrence of medical malpractice could be reduced by the clinical doctors through improving serve consciousness, obtaining the patients' trust, improving the medical treatment, following related laws and rules, fulfiling duty of medical careness.
Adult ; Age Distribution ; Expert Testimony ; Female ; Forensic Pathology ; Hospital Administration ; Humans ; Liability, Legal ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Middle Aged ; Neoplasms/therapy* ; Retrospective Studies ; Sex Distribution

OBJECTIVE: To investigate the causes and features of medical disputes in percutaneous coronary intervention (PCI) in the cardiology and to provide references for forensic expert testimony and medical disputes prevention. METHODS: Fifty one disputed fatal cases in PCI were analyzed in terms of the cause of death, informed consent and medical operations retrospectively. RESULTS: Thirty five cases were due to medical negligence, 28 due to defect technical operation, 2 due to mistake medical management and 5 due to both defect technical operation and mistake medical management. CONCLUSION The causes of PCI medical negligence are defect medical operation, violate medical disciplines and insufficiency of informed consent.
Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cause of Death ; Coronary Artery Disease/therapy* ; Expert Testimony ; Female ; Humans ; Male ; Malpractice ; Medical Errors/statistics & numerical data* ; Middle Aged ; Myocardial Infarction/etiology* ; Postoperative Complications/etiology* ; Retrospective Studies

OBJECTIVE: To study the rules of forensic expertise on medical disputes in obstetrics and gynecology, and the characteristics of medical faults in order to provide theoretical supports for forensic expertise. METHODS: Eighty two cases of forensic expertise on medical disputes in obstetrics and gynecology were respectively analyzed, which were performed in Forensic Science Center of West China from 2002 to 2008. RESULTS: It has been found that cases of forensic expertise on medical disputes in obstetrics and gynecology were increasing year by year, with more dispute cases from municipal (district) and county hospitals than other hospitals. More disputes involved in childbearing and surgery cases. The main reasons of the medical faults were due to defects of medical techniques and managements. CONCLUSION The forensic expertise of medical dispute must focus on the corresponding clinical regulations and whether the doctor fulfill their obligations. Meanwhile, whether there are physician negligence, technique faults and management defects should be investigated.
Adult ; Expert Testimony ; Female ; Forensic Medicine ; Gynecology ; Humans ; Malpractice/statistics & numerical data* ; Medical Errors/prevention & control* ; Obstetrics ; Pregnancy ; Professional Misconduct ; Retrospective Studies

OBJECTIVE: To analyze the main causes of medical dispute and the main types of medical malpractice. The related problems were discussed in forensic expertise. METHODS: Forty cases of medical dispute from 2006 to 2008 in our institute were analyzed retrospectively. RESULTS: In 40 cases of medical dispute, city-level hospitals, county-level hospitals, town-level hospitals and private clinics were 11 (27.5%), 24 (60.0%), 2 (5.0%) and 3 (7.5%) cases respectively. The internal medicine departments, surgical departments, gynaecological and obstetric departments, pediatric departments and outpatient center were 16 (40.0%),10 (25.0%), 9 (22.5%), 2 (5.0%) and 3 (7.5%) cases, respectively. The amount of cases from city-level hospitals, county-level hospitals diagnosed by the medical experts as the medical malpractice showed less than that from town-level hospitals and private clinics. CONCLUSION The amount of cases of medical dispute from city-level and county-level hospitals were more than that of town-level hospitals. But the amount of cases diagnosed by the medical experts as medical malpractice from city-level and county-level hospitals were less than that of town-level hospital and private clinics.
Expert Testimony ; Female ; Forensic Medicine ; Hospitals, County ; Hospitals, Urban ; Humans ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies