Civil medical liability in cardiology: a systematic review

Civil medical liability in cardiology is an important but fragmented field. The specialty's emergent nature, high-risk conditions, complex diagnostic processes, and invasive procedures increase the likelihood of claims following adverse or preventable events. However, comprehensive data on the causes of claims and their financial impact are limited. This review synthesizes evidence on the primary causes of claims against cardiologists and the associated compensation amounts. The review was conducted in accordance with the PRISMA 2020 guidelines. A systematic search of PubMed and Scopus was performed using terms related to cardiology, medical negligence, and legal claims. Studies that provided extractable data on the causes of claims or compensation amounts were included. Following full-text screening of 28 articles, 16 studies met the inclusion criteria. Studies were conducted primarily in the United States, with additional data from Greece, Turkey, Taiwan, and South Korea. Claims most commonly involved diagnostic errors or delays, particularly those related to myocardial infarction, acute coronary syndrome, aortic dissection, and cardiomyopathies. Other contributing factors included failures in testing or interpretation, procedural complications, treatment delays, and inadequate communication, informed consent, follow-up, or documentation. Compensation, reported in 10 of the 16 studies, varied widely, ranging from modest sums to multimillion-dollar awards. Higher payouts were associated with diagnostic errors, inappropriate treatment, and procedural complications. Civil liability in cardiology largely stems from diagnostic errors, insufficient investigation, procedural complications, and inadequate patient information or follow-up. Medicolegal risk depends less on outcomes than on whether care was timely, well-documented, and consistent with accepted standards. Recognizing common patterns of claims may enhance patient safety, education, and quality of care.