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Empirical analysis of medical malpractice litigation involving urgent-care settings in the Spanish national health service

Hernández-Herrero M, Cayón-De las Cuevas J

Servicio d Urgencias, Hospital Comarcal de Laredo, Instituto de Investigación Sanitaria Valdecilla, IDIVAL, Cantabria, Spain. Grupo de Investigación en Derecho Sanitario y Bioética, Instituto de Investigación Sanitaria Valdecilla, IDIVAL- Universidad de Cantabria, Spain.

Background and objective. To analyze the characteristics of superior court decisions in litigation or administrative procedures for medical malpractice claims involving urgent care settings in the Spanish national health service.
Methods. Observational cross-sectional study of judicial rulings handed down between 2008 and 2020 in cases involving urgent care. We analyzed administrative, clinical, and judicial variables as well as the amounts of compensation awarded.
Results. A total of 1015 rulings were analyzed; 243 cases (23.9%) involved urgent medical care. Most cases (223 [91.8%]) involved elderly patients. The largest proportion of defendants (97 [39.9%]) were emergency physicians, and the most common setting was a hospital emergency department (211 [86.8%]). The grounds for finding against the defendant were most often diagnostic or therapeutic error (40 [46.0%] cases) and lost opportunity (35 [40.2%] cases). Damages were usually claimed for sequelae (122 [50.2%] cases) and death (112 [46.1%] cases). The median award was €46 000, the minimum was €1300, and the maximum was €974 849.
Conclusions. In medical and other health-care malpractice cases, the majority of claims (about 64%) are dismissed. This finding, unreported until now, may help to contain the overestimation of risk of liability in urgent medical care. It also reinforces the need to provide medical practitioners with more training regarding the legal aspects of health care.

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