Medical malpractice frequency in the psychiatric field, in medical council of Iran, from 2001 to 2010: a brief report

Identify the causes of complaints and contributing factors may reduce medical litigation. The aim of this study was to assess the cases of complaints in the field of psychiatric. This study was done in retrospective cross-sectional study method. We investigated 27 cases of medical malpractice in the field of psychiatry that registered in higher disciplinary board of the Medical Council of Iran, from 2001 to 2010. We calculated the absolute and relative frequency of variables after collecting all data and calculated the difference between malpractice and exculpation cases based on physicians profile by Pearson's chi-squared test and Fisher's exact test. P< 0.05 was considered as statistically significant difference. The 24 people who died and their families protested against psychiatrist were enrolled in this study. Demographic information and other characteristics of the cases were collected. All participants had been men. Seventeen of 24 cases [70.84%] were in 30-50 year old group and seven of 24 cases [29.16%] were in > 50 year old group. The most common types of negligence were related to disregarding of governmental provisions [40%]. The age, expertise and place of medical activities were variables that different significantly between negligence and non-negligence groups [P< 0.05]. The results of the study showed eight cases of 24 cases [33%] in the lower board, nine cases of 24 cases [37.5%] in the appeals board and eight cases of 24 cases [33%] in the higher disciplinary board were acquitted. Based on the study findings, it appears that age, expertise and practice location are factors that can be effective in reducing malpractice in psychiatry

Assessment of records of complaints from medical malpractice in the field of orthopedic, in the coroner's office of forensic medicine, province of Tehran, during 1988 to 2003

In spite of the numerous advancements in diagnosis and treatment of the disease, today lodging files against physicians and medical assistants is increasing. Population growth, social awareness growth, and growing number of physicians, as well as implementation of complex and modern devices in diagnosis and treatment of the diseases are among the reason for such complains. Moreover, the lessening of traditional relationship between patient and physician accelerates this phenomenon. The aim of our study was to asses etiologies and motivations of complains, rate and type of malpractice and at last find a solution for decreasing physicians' Malpractice. In a retrospective descriptive-Analytic study we evaluated the records of medical malpractice in the field of orthopedic during 1998 to 2003, in the coroner's office of Forensic Medicine, province of Tehran. During this time among 965 cases of medical malpractice, 196 [20.31%] have been related to this field. This process has increased from 15 cases in 1998 to 39 cases in 2003. In 60.72% of the cases acquittal verdict, and in 39.28% of the cases malpractice verdict have been issued, Of the total number of the cases 54.59% of them have been related to private centers, 17.86% related to non academic governmental centers, and 21.94% were related to university centers and 5.61% related to charity centers. However, malpractice rate in these centers has been 52.34%, 22.86% 20.93% and 36.36% respectively 9.09% of the malpractice cases resulted in the death of the patient, the rest resulted in physical handicap, and deficiency. Improvement in the patient - physician relations, implementation of medical ethics, decrease in related financial affairs, improvement of professional skills and knowledge of the physicians, adequate briefing of the patients before diagnostic and therapeutic procedures, and accommodation of therapeutic centers with the advanced technical equipments has significant effect on the lessening of ignorance and complaints

report of a medical malpractice induced death due to dipyridamol thalium perfusion scan

Currently Fschemic Heart Diseases are evaluated by nuclear techniques imaging of mqocardical perfasion. Cardiologist with CPR instruments Should be Stated in all nuclear imaging Centers. Our patient was a 56 years old woman with a history of hypertension and ischemic heart disease which was hospitalized because of acute pulmonary edema in a hospital in 2003.During hospitalization period her cardiac enzymes rose. Her lectrocardiograph showed left bundle branch block pattern and her Ejection Fraction in echocardiography was 40%. 2 days after dicharge from the hospital according to her doctor advice referred to a nuclear medicine center for Dipyridamol Thalium Scan Perfusion test [SPECT] at 8.30 pm. During infusion of scan specific drug she complained of headache, cough and dyspnea which were relived with primary cares.During this period she was under observation of a cardilogist. After infusion she waited in the waiting room until the time of imaging .After one hour and a half gamma camera imaging began and at the 15th min of imaging process she complained of dyspnea and her respiratory rate began to decrease. At this time, 2 imaging technicians and one nurse which were available on her side began primary cardiopulmonary resuscitation and then she was transferred to the emergency center of a hospital. CPR continued and the patient was admitted to ICU. At 1.30 Am of the following day she died at ICU and death certificate was issued for her at the hospital without biopsy. Following protest of her family, the case was propounded in one of the especial commissions of legal medicine organization and the final decision of the commission was declared as follows: The role of burden of disease in death of the patient: 75% The role of technical assistant of the institute in death of the patient because of not existence at the institute during the test ant not programming for attendance of a cardiologist during all phases of the test: 15% The role of cardiologist in death of the patient because of not following the patient procedure and leaving institute before the end of imaging process: 10%. At the majority of cases, the only reason that causes our physicians in spite of their wisdom and specialty are found guilty in the courts is unawareness of their legal responsibilities. The other important point in this case is issuing the death certificate without referring the cadaver to the legal medicine center for biopsy which could change the outcome of the court

Epidemiologic study of deaths due to burns in Tehran [march 2005 to march 2006]

Burn injuries still produce significant mortality in Iran. In order to assist with the prevention of burn injuries, the epidemiology of fatal burns in Tehran was investigated. In a retrospective study, which was based on post mortem examination, with their clinical and juridical information, this study was carried out to analyze the epidemiology, mortality, and current etiological factors of 388 deaths due to burn, which were referred to the legal medicine center of Tehran between 20/3/2005 and 20/3/2006. Results were compared with similar information in five past years. The overall incidence rate of death was 3.3 per 100000 person-years. The mean age was 27.8 years [age range, 4 months to 77 years], and 24% of them were under 19-years-old. [61%] of all the victims were male and [390%] were female, [M/F=1.5]. The highest incidence of burns was in the 21 - 30 age group [30.4%]. Total burn surface area [TBSA] in the most of cases [86.6%] was more than 40%, and had a significant negative correlation with hospitalization length. Flame was the most common etiology of burns [90.7%]. Accidents were the major manner of death [74%]. Suicide [16.2%], murder [2.6%], and undetermined [7.2%] were other manners of death. Rate of suicide for all the patients > or = 11 years were the cause of 22.7% [34/150] of the burns involving women and of 13% [27/208] of the burns involving men. Houses were the most common sites of burning [71.1%] and major cause of them were kerosene and gas accidents. The mean length of hospitalization befor deeth was 10 days. Factors associated with an increase in mortality were suicidal burns, burn size, age, inhalation lesions and flame burns. Most of the burn injuries were caused by domestic accidents and were, therefore, preventable. Parents can play an important role in prevention of burns in children who are most susceptible to burns. People with causes identified could be educated in burn prevention, through news and the media. Decrease of mortality rate in five past years can be as sign of progress in prevention and treatment of burn injuries