بررسي پرونده هاي شكايت از قصور پزشكي در رشته تخصصي ارتوپدي در اداره كل پزشكي قانوني استان تهران طي سالهاي 1382-1377

Assessment of records of complaints from medical malpractice in the field of orthopedic, in the coronerʹs Office of Forensic Medicine, province of Tehran,during 1988 to 2003.

Background and Aim: 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 ʹMalpractice. Materials and Methods: 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. Findings: 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, and21.94% 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. Conclusion: 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.