Obstetric and gynecologic malpractice in Turkey: incidence, impact, causes and prevention

The Forensic Medicine Association was established in Turkey by law number 2659 for the purpose of providing expertise in legal cases. In this study the opinions given by the lawcourts and public defenders in the Forensic Medicine Association's First, Second, Third, and Fifth Specialization Divisions between the years 1990 and 2000 (approximately 680,000 files) were examined retrospectively. It was determined from these that there were 636 cases of medical malpractice. In examining the distribution of cases based on specialty branch, it was established that 16.82% (n=107) were in the area of obstetrics and gynecology, 10.69% (n=68) in general surgery, 10.53% in neurology and neurosurgery, and the remaining areas were found to be at lower percentages. It also showed that in recent years there has been an increase in the number of cases claiming medical malpractice in the area of obstetrics and gynecology, and that 58% of the cases (n=62) from 1998 to 2000 were in this area. 96% of the 107 cases that claimed malpractice in the area of obstetrics and gynecology were found to be related to obstetrics and 3.8% (n=4) to gynecology and surgical procedures. In 31% (n=33) of the 107 cases fault was found; all of the cases where medical malpractice was found were in the area of obstetrics and none of the cases related to gynecology were found to have an element of error. Cases that had an element of error were evaluated from the aspect of profession of the health care personnel at fault, areas of fault, places where fault occurred, situations that resulted in death, cause of death, whether or not an autopsy was done, injury that resulted from fault, intervention that was done, and obstetric and gynecologic risk factors that set the stage for claims. Care standards and breach of standards were examined.