The pattern of medical errors and litigation against doctors in Saudi Arabia.

BACKGROUND: Adverse events are frequent in clinical practice, but only a few studies in Saudi Arabia have addressed them. The current study was designed to review the lawsuits against healthcare professionals by analyzing records of the cases dealt with by the Medico-legal Committees (MLC) in various provinces in Saudi Arabia, in order to determine the pattern of medical errors and litigations in the country. MATERIALS AND METHODS: A pre-designed data sheet was used to collect data from the records of the Medical Violation Committee (MVC) and the Medical Jurisprudence Committee (MJC). The data sheets consisted of information on details of the cases, details on where the error had occurred, and details of the errors. RESULTS: The review of records revealed 642 cases, most of which were from hospitals run by the Ministry of Health (MOH). The operating room was where most of the errors (20.4%) had occurred, followed by the emergency room (18.1%). Surgery was at the top of the specialties (25.1%). Most of the deaths occurred in surgery and obstetrics (about 25% for each), followed by other medical specialties (17%). About half of the lawsuit cases studied (46.5%) involved patients belonging to a relatively young age group (20-50 years). CONCLUSION: Most of the medical error litigations involved surgeons and obstetricians especially in MOH hospitals. The process of litigations and documentation need to be improved, and access to the records for research and education need to be made easier. In addition, there is a need for more prospective field studies.

The velocity of fetal growth is associated with the breadth of the placental surface, but not with the length.

OBJECTIVES: Studies of the placenta in pregnancies complicated by pre-eclampsia have led to the suggestion that tissue along the length and breadth of its surface has different functions. A recent study in Saudi Arabia showed that the body size of newborn babies was related to the breadth of the surface at birth but not to its length. We have now examined whether the association between placental breadth and body size reflects large size of the baby from an early stage of gestation or rapid growth between early and late gestation. METHODS: We studied 230 women who gave birth to singleton babies in King Khalid Hospital, Riyadh, Saudi Arabia. In total, 176 had ultrasound measurements both before 28 weeks and at 28 weeks or later, which we define as early and late gestation. We used these to calculate growth velocities between early and late gestation, which we expressed as the change in standard deviation scores over a 10-week period. RESULTS: The breadth of the placental surface was correlated with fetal growth velocity. The correlation coefficients were 0.24 (P = 0.002) for the head circumference, 0.24 (P = 0.001) for the biparietal diameter and 0.34 (P < 0.001) for the abdominal circumference. The length of the surface was not related to fetal growth velocity. CONCLUSIONS: Tissue along the breadth of the placental surface may be more important than tissue along the length in the transfer of nutrients from mother to baby. This may be part of a wider phenomenon of regional differences in function across the placental surface.