Medical Injury And Medical Negligence In Obstetrical And Gynecological Malpractice Cases

Background:Though malpractice has been increasingly high on profile in medical community and the society as a whole,risk factors for malpractice remain poorly understood and still a controversy in China,especially the relationships between medical injury,negligence of health providers and medical malpractice.Objectives:To identify the relationships between medical injuries and negligence with malpractice in Obstetrical and Gynecological departments.To provide scientific evidence for policy making in medical malpractice prevention.Methods:We identified 44 malpractice cases happened from 2004 to 2007 from Obstetrical and Gynecological departments of two major county children& women hospitals in Beijing,and 98 controlled patients matched with malpractice ones.Conditional Logistic regression were utilized to estimate the odds ratios of potential risk factors for malpractice.Results: We found that comparing with controls,patients with malpractice are more likely to suffer from medical injury(88.6%vs 6.1%,p＜0.001) and medial negligence(84.1%vs 8.2%,p＜0.001).Medical injuries are more likely to be moderate to severe in malpractice patients,comparing with control patients(p=0.031).Medical negligence is more likely to attributable to medical providers,comparing with control patients(89.2% vs 50%,p=0.007).For malpractice patients,medical injuries and negligence are more likely to be associated with failure technical procedure,while in control group it has more to do with poor diagnosis (not statistically significant).Univariate conditional logistic regression showed that patients with medical injury(OR=76.08,95%CI: 10.33～560.2) and negligence(OR=63.19,95%CI:8.53～468.3) are 76 and 63 times more likely to have medical malpractice dispute respectively.The risk increases 8 times respectively with the increase of injury severity level(OR=8.02,95%CI:3.00～21.45) and physicians' negligence level(OR=8.06,95%CI:2.62～24.78).However,multivariate conditional logistic regression showed only physicians' negligence level associated with increased risk of malpractice(95%Confidence Interval: 1.879～33.23).Conclusion:Moderate to severe medical injury and physicians' medical negligence significantly increases patients' risk of malpractice in Ob/Gyn departments.