Analysis of closed malpractice medical claims against Taiwanese EDs: 2003 to 2012
Kuan-Han Wu1, Chien-Hung Wu1, Shih-Yu Cheng1
1Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung County 833, Taiwan.
Objectives:
The objective of the study is to examine the epidemiologic data of closed malpractice medical claims against emergency departments (EDs) in Taiwanese civil courts and to identify high-risk diseases.
Methods:
We conducted a retrospective study and reviewed the verdicts from the national database of the Taiwan judicial system that pertained to EDs. Between 2003 and 2012, a total of 63 closed medical claims were included.
Results:
Seven cases (11.1%) resulted in an indemnity payment, 55.6% of the cases were closed in the district court, but appeals were made to the supreme court in 12 cases (19.1%). The mean incident-to-litigation closure time was 57.7 ± 26.8 months. Of the cases with indemnity paid, 5 cases (71.4%) were deceased, and 2 cases (28.6%) were gravely injured. All cases with indemnity paid were determined to be negligent by a medical appraisal. The gravely injured patients had more indemnity paid than deceased patients ($299800 ± 37000 vs $68700 ± 29300). The most common medical conditions involved were infectious diseases (27.0%), central nervous system bleeding (15.9%), and trauma cases (12.7%). It was also found that 71.4% of the allegations forming the basis of the lawsuit were diagnosis related.
Conclusions:
Emergency physicians (EPs) in Taiwan have similar medico-legal risk as American EPs, with an annual risk of being sued of 0.63%. Almost 90% of EPs win their cases but spend 58 months in litigation, and the mean indemnity payment was $134738. Cases with indemnity paid were mostly categorized as having diagnosis errors, with the leading cause of error as failure to order an appropriate diagnostic test.
