Research on anesthesia malpractice cases reviewed by the supreme health council of the republic of turkey between 2000 - 2009

Our research aims to retrospectively examine anesthesia malpractice cases, specifically those resulting in injury and/or death, which were reviewed by the Turkish Supreme Health Council between 2000 - 2009. The purpose of this research is to extract a profile of anethesia malpractice, and introduce the legal procedure in Turkey for malpractice claims.During this time period, 1818 files were sent from the criminal courts to the Turkish Supreme Health Council for expert review. Of those cases, 112 (% 6,1) of them could be considered to be directly related to anethesia malpractice. Furthermore, these cases were further examined under predetermined categories. Without knowing the final decision of the courts in these cases, about half of the cases taken up by the Turkish Supreme Health Council concluded in malpractice decisions. In 83 instances, the surgeon was found as the guilty party in anesthesia-related malpractice cases. The Turkish Supreme Health Council determined that the surgeon was at fault in % 49,3 of these cases. In 68 cases where the anesthesiologist introduced the anesthesia, % 52,9 of the time, the anesthesiologist was at fault. Not a single anesthesia technician was ever found to be guilty of malpractice alone. However, % 40 of the cases involving an anesthesia technician, a fault in the anesthesia practice was discovered. Twelve cases were sent to the Turkish Supreme Health Council because of inproper use of anesthesia in the absence of anesthesiologists and/or anesthesia technicians, and in all instances the implementation of anesthesia was found to be flawed.The most common mistakes in the practice of anesthesia include inadequate follow-up and a lack of attention and care (% 36,6). The second most common complication is related to respiratory safety (% 25,9). The third most common complication comes from the lack of a thorough preoperative evaluation and physical examination (% 20,9).The most frequent reason for filing suits related to anesthesia malpractice include death (% 83,9) and hypoxic cerebral injury (% 6,3). In the cases that resulted in death, the patient died in 24 cases (% 25,5) after 24 hours of anesthesia implementation, and in 23 cases (% 24,5) death occurred while receiving anesthesia.In conclusion, the undesireable results of anesthesia primarily occurred under circumstances where: there was no anesthesiologist present; or the anesthesia was delivered by a doctor who is a specialist in another practice area; or the anesthesia was delivered by an anesthesia technician not under the supervision of the aforementioned doctors. As a result, in the cases of anesthesia malpractice, the failure rates for surgeons and anesthesiologists are nearly the same. In Turkey, the current legal framework should be reviewed to ensure that anesthesia should only be administered under the supervision of an anesthesiologist, thus making receiving anesthesia much safer for patients.Keywords: Anesthesia, malpractice, The Supreme Health Council