[Categories for evaluating surgical procedures by expert medical witnesses]

An analytical procedure is presented that helps to determine the causes of surgical malpractice. A first evaluation scale of six levels is applied to the assessment of the indications for surgery and the method used as well as a second scale for the technical realisation of the treatment. For the indication and method categories A-F are used.A: method of choice; B: a time-tested method but second choice; C: exceptional method, rarely practised; D: historical method no longer in use; E: incorrect method/simple mistake; F: blatant mistake in the assessment of indication or choice of method, not understandable. To evaluate the technical realisation of treatment a scale from 1 to 6 is applied. 1: excellent realisation; 2: successful, but minor drawbacks; 3: atypical but acceptable result; 4: technically failed but no harm to the patient; 5: insufficient realisation; 6: faulty, grossly failed. Three cases are given as examples. In these cases the use of the proposed categories and scaling leads to differentiated assessments.