Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis

Objectives: Medical malpractice complaints are apparently on the rise in Ghana. Though it has been suggested that medico-legal training programmes should emphasise the kinds of legal problems that healthcare staff encounter most frequently in practice, no comprehensive study currently analyses the pattern and outcomes of existing case laws. Design: Systematic content analysisData sources: Medical malpractice case laws sourced from Ghanaian legal repositories, media platforms and other grey literature sources. Results: Nine case laws were retained. Most of the cases (n=7) involved negligence. Emerging patterns of cases are complex, including patients' access to their medical records, practising without a license/ out of scope, refusal to treat, and the development of complications following surgical interventions. Obstetrics & Gynaecology, Surgery, and Paediatrics were the main clinical specialties involved in the malpractice cases identified. Conclusions: The pattern of the cases suggests that all medical specialties are potentially at risk, although most of the cases emerged from Obstetrics & Gynaecology, Surgery, and Paediatrics. Medico-legal training for healthcare staff should emphasise the duty of care and adherence to the Ghana Health Service Patient Charter

Sufficient informed consent to medical treatment of adults legal and ethical perspectives from Malawi

This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under civil law. Inconsistencies and uncertainties in the law are made apparent. It evaluates to which degree disclosure standards of other Commonwealth jurisdictions (e.g. the case of Montgomery) would be suitable for the health care setting of a country like Malawi that is characterized by shortages of resources, high illiteracy rates and a communitarian cultural context. Doctor-patient communication is not alien to African culture and part of sufficient informed consent. In order to balance the need for efficiency in health care delivery, accountability for quality care, fairness and effective patient-doctor communication the authors suggest to adopt the reasonable patient test only, if a defence of heavy workload on case-to-case basis is introduced at the same time. This does not dispense the need for organisational diligence on part of the institutional health care provider within its capacity

Pratique chirurgicale et sécurité du patient à l'hôpital régional et à l'hôpital protestant de Ngaoundéré

Introduction. La check-list (CL) a montré son efficacité pour réduire les complications chirurgicales dans plusieurs pays du monde où elle a été implémentée. Notre travail avait pour but d'étudier sa valeur à Ngaoundere et l'intérêt de son implémentation dans nos hôpitaux. Son objectif était d'identifier à l'aide de la CL les moyens de prévention et/ou de gestions des erreurs indésirables dans le cadre de la sécurité chirurgicale des patients. Matériels et méthodes. Nous avons mené une enquête descriptive rétrospective et prospective, en utilisant un questionnaire de type audit CL. Les paramètres évalués étaient les moyens de prévention utilisés, le type d'erreurs ou d'événement indésirable grave (EIG) observés et les raisons à l'origine de ces EIG dans un gran hôpital public de Ngaoundere et dans un grand hôpital privé de Ngaoundere. Résultats. 38 personnels ont participé à l'étude. 28,95% de ces personnels utilisaient comme moyen de prévention « la dénonciation » et 57,89% des personnels « l'archivage ». Le personnel a déclaré comme principaux EIG: les effets néfastes de l'administration des drogues, les hémorragies postopératoires, les pertes de fonction respiratoire, les infections postopératoires, et les allergies. Les principales raisons à l'origine de ces EIG étaient comme la communication défectueuse (67,47%), le manque d'outil de surveillance (25,52%) et la fatigue (12,38%). Conclusion. L'examen du type d'EIG et des raisons à l'origine de ces EIG laisse penser que la check-list opératoire, par sa facilitation de la standardisation du travail d'équipe peut améliorer la sécurité du patient chirurgical à Ngaoundere

Criminal Liability: Negligence and Environmental Health

Lack of compliance to effluent discharge standards in the waste water treatment industry lead to the discharge of poor quality effluents which cause increased levels of health risks in South Africa. No case law exists in South Africa to serve as precedent to enforce the criminal liability of individuals and water treatment entities. The author utilises the Bloemhof Municipality case study to illustrate the possible application of criminal action concerning the negligence in waste water treatment which; in turn; has been tested and instituted successfully in terms of environmental transgressions against both corporate structures and individuals in the mining industry. South African courts have to give consideration to the prospect of criminal action in the waste water treatment industry to deter sustained inadequate purification of raw water and inadequate treated effluent discharges in our water resources

Analysis of Medical Malpractice Clams and Measures Proposed by the Health Professionals Ethics Federal Committee of Ethiopia: Review of the Three Years Proceedings

Background: Medical malpractice is professional negligence by a healthcare provider in which the treatment provided falls below the standard and causes injury or death to the patient. Objective: To describe the adverse medical events; claims and decisions taken by the Ethiopian Health professionals Ethics Committee at the Federal level. Methods: A three-year report of the Ethics Committee and relevant documents of proclamations and regulations were reviewed. Results: Between January 2011 and December 2013; the committee reviewed 60 complaints against health professionals. About one third of the complaints were filed by the patients and/or their families; about 32 by the police or court and the rest were filed by Addis Ababa health bureau; health professionals and other unrelate4d observers. Thirty-nine complaints were related to death of the patient and 15 complaints were about disability. Twenty-five of the claims were against Obstetric and Gynecology specialists and 9 were against general surgeons. The committee verified that 14 of the 60 claims had ethical breach and/or negligence (incompetence). The committee took reasonable time to review complaints and respond the concerned authorities. Conclusion: The study showed that of the total claims lower than a quarter (23.3) were proven beyond the benefit of doubt. More than 3/4 (76.7) of the complaints were wrong. Hospitals should lead in preventing patient injury. Creation of more awareness among Obstetrics and Gynecology specialists; General and Orthopaedic Surgeons about medical errors is needed and special training should be given to those joining these specialities