Association between reportable preventable adverse events and unfavorable decisions in medical malpractice claims involving obstetricians covered by FEPASDE Colombia 1999 to 2014. Case-control study

  • Hernando Gaitan-Duarte a. Department of Gynecology and Obstetrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia. b. Clinical Research Institute, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia. c. Hospital Universitario Nacional de Colombia, Universidad Nacional de Colombia, Bogotá, Colombia.
  • Javier Eslava-Schmalbach a. Clinical Research Institute, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia. b. Hospital Universitario Nacional de Colombia, Universidad Nacional de Colombia, Bogotá, Colombia.
  • Luisa Montoya Research Division, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
  • Gloria Jiménez Medical Advisory Area, Colombian Society of Anesthesia and Resuscitation (S.C.A.R.E.), Bogotá, Colombia.
  • Jorge Medina-Parra Clinical Research Institute, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
  • Carmen Doris Garzón-Olivares Department of Gynecology and Obstetrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
  • Mauricio Vasco a. Obstetrics Anesthesia Committee, World Federation of Societies of Anesthesiologists (WFSA), Medellin, Colombia. b. Colombian Society of Anesthesia and Resuscitation (S.C.A.R.E.), Bogotá, Colombia.
  • Liliana Arango-Rodríguez Colombian Society of Anesthesia and Resuscitation (S.C.A.R.E.), Bogotá, Colombia.
  • Iván Andrés Cediel-Carrillo Colombian Society of Anesthesia and Resuscitation (S.C.A.R.E.), Bogotá, Colombia.
Keywords: Obstetrics, Legal Process, Liability; Legal, Propensity Score, Colombia

Abstract

Introduction:

Reportable, preventable events are potential causes for medical liability litigation. It is important to determine whether the occurrence of such events increases the risk of unfavorable legal or ethical decisions.

Objective:

To assess the association between the occurrence of a reportable preventable event and unfavorable legal and ethical decisions in medical liability processes against obstetricians.

Materials and methods:

Case-control study. Population: obstetricians affiliated to FEPASDE, with legal or ethical claims closed between 1999 and 2014 in Colombia. Cases: obstetricians with unfavorable judicial decision in malpractice claims. Controls: obstetricians with a favorable judicial decision. Sample: 322 subjects (64 cases, 258 controls). Analysis: variables concerning the obstetrician, the institution, the process, and the patient were measured. Bi-varied and multivaried analyses with a logistic regression model were conducted, using a propensity score or index.

Results:

An association was identified between the occurrence of the reportable preventable event and an unfavorable ruling (OR=4,4; CI 95%: 2,23 - 8,76). Other associated factors included: private institution (OR = 2.3 95% CI: 1.14-4.51), type of civil claim (OR = 14.1 95% CI: 5.51-36.04), product diagnosis-demise (OR = 3.1 95% CI: 1.64-5.94), history of other unfavorable proceedings (OR = 2.3 95% CI: 1.27-4.06). Inadequacies in the prevention and medication therapy were associated with an unfavorable ruling (P < 0.05).

Conclusion:

The presence of reportable preventable events is associated with an unfavorable legal or ethical decision in malpractice claims involving obstetricians. Inadequate patient management and poor functioning of the hospital care system provide opportunities for intervention to reduce the risk of an unfavorable legal or ethical decisions in malpractice claims.

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How to Cite
1.
Gaitan-Duarte H, Eslava-Schmalbach J, Montoya L, Jiménez G, Medina-Parra J, Garzón-Olivares CD, Vasco M, Arango-Rodríguez L, Cediel-Carrillo IA. Association between reportable preventable adverse events and unfavorable decisions in medical malpractice claims involving obstetricians covered by FEPASDE Colombia 1999 to 2014. Case-control study. Colomb. J. Anesthesiol. [Internet]. 2019Jan.1 [cited 2021May10];47(1):14-2. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/119

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Published
2019-01-01
How to Cite
1.
Gaitan-Duarte H, Eslava-Schmalbach J, Montoya L, Jiménez G, Medina-Parra J, Garzón-Olivares CD, Vasco M, Arango-Rodríguez L, Cediel-Carrillo IA. Association between reportable preventable adverse events and unfavorable decisions in medical malpractice claims involving obstetricians covered by FEPASDE Colombia 1999 to 2014. Case-control study. Colomb. J. Anesthesiol. [Internet]. 2019Jan.1 [cited 2021May10];47(1):14-2. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/119
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