Epidemiology of medico-legal litigations and related medical errors in central and northern Saudi Arabia. a retrospective prevalence study

ABSTRACT

To study medico-legal litigations and related medical errors in Central [Al-Qassim], and Northern [Hael] districts in the Kingdom of Saudi Arabia [KSA], and to identify types and causes of errors to reduce medical errors and patient harm. This retrospective prevalence study was carried out between May 2010 and December 2011 to analyze medico-legal litigations in Al-Qassim and Hael districts that were investigated by the Al-Qassim Medico-Legal Committee, Al-Qassim, KSA. Final verdicts issued between 1992 and 2009 included 293 cases. The patient's mean age was 29.5 years. Fiftyseven percent of the patients were females, and 92% were Saudis. The Obstetric and Gynecology department was involved in 29.7% of litigations followed by General Surgery, and Pediatrics [11.3% each]. Of the 635 defendants, 90% were physicians, and 7.6% were nurses. Investigations showed "no error" in 47.1% of cases, "error but no harm" in 11.9%, and "error resulted in harm" in 39.6%. Errors were negligence [45.8%], wrong diagnosis [14.2%], surgical error [10.3%], and administrative error [5.2%]. The average total duration of litigations was 13.9 months. "Type of harm" was the most significant predictor to determine a "guilty" decision [p<0.001]. Obstetric practice in Al-Qassim and Hael districts and provider negligence contribute to a large portion of medico-legal litigations, and therefore this has to be further studied to recognize the specific causes and possible interventions. A systematic review of the medico-legal committee is needed to shorten the long duration of litigation