Assessment of the medical malpractice cases of which forensic reports were drawn up BY Dokuz Eylül University forensic medicine department between 2014 and 2021

Introduction: The number of claims of illnesses, disability or death as a result of medical negligence is increasing steadily. This may be due to the increase in awareness and knowledge of the patients, or their relatives on the matter. Not only some policies, legal regulations, and the negative attitudes of the media are exacerbating factors, but thanks to the advancements in medicine and technology, it is now possible to perform more risky and complex medical procedures which were not very possible previously. To reduce the pressure on healthcare professionals and improve the quality of healthcare services, it is of great importance that the issue should be discussed in a multifaceted and detailed manner. This study is aimed at discussing different approaches to medical malpractice cases and discussing various perspectives on them. By doing so, we hope to contribute to the scientific discussions with the available data and literature information on this subject and discuss the methods to be followed in the assessments of malpractice cases. Materials and Methods: The cases referred to our department between 01.01.2014 and 31.12.2021 were reviewed retrospectively. Such cases were referred either due to the alleged medical malpractice by official authorities or through individual applications for medicolegal assessments. Demographic data, healthcare unit, clinical unit, subjects of the claim, reasons, whether the case resulted in death or not, the form of the application, comparison of our expert opinion with the other institutions and the final case verdict information were obtained. The data were evaluated by using the SPSS 26.0 program. Findings: 92 cases were evaluated in total. It was demonstrated that 56.5% (52) of the cases were female, and the mean age was 39.36 ± 19.32 years. Additionally, it was revealed that the first institution that the patients sought treatment from and the most frequent subject of the allegations were private healthcare providers with a rate of %64.1. It was demonstrated that the most frequent clinical branch subject to allegations was surgery with 58.7%, and the most frequent speciality subject to allegations was gynaecology and obstetrics with %17.4. A statistically significant correlation was found between whether the claim of medical malpractice resulted in death and the type of application made to us (p<0.001). Similarly, a statistically significant correlation was found between whether or not the claim of medical malpractice resulted in death and the clinical branch subject to the claims (p=0.016). When the nature of the medical malpractice claims was examined, it was indicated that the treatment errors were the chief among them with 56 cases. Among the causes of medical malpractice, treatment errors and lack of care and lack of attention were seen to be the largest group with 7 cases each. Discussion and Conclusion: It was concluded that surgical specialities were the most common subject of medical malpractice claims in our study, similar to other studies in Turkey. Doctors choose such specialities as their career pathways less frequently than ever before because they perceive them as risky, in terms of malpractice possibility and potential consequences of it. It is necessary to reduce the malpractice fear and its negative effects on healthcare workers, by preventing disinformation in the media, optimizing working conditions and proper and prompt resolution of such cases. Therefore, although the expert witness procedure is important for revealing the existing deficiencies and the right/unjustified sides of the parties, we believe that it should be criticized through different channels and thus its objectivity and reliability should be increased. Keywords: Medical malpractice, expert witness, clinical unit, forensic medicine