Obstetrics-Gynecology Litigation: 17 Years of Medico-Legal Experience in Professional Liability Watchdog

Matteo Bolcato^1*, Giacomo Fassina², Irene Borgato¹, Matteo Sanavio², Daniele Rodriguez¹, Anna Aprile¹

¹Legal Medicine, Department of Molecular Medicine, University of Padua, Padua, Italy - ²Legal Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy

Background: Medical liability in obstetrics-gynecology is a phenomenon of great impact in professional liability disputes. 

Methods: This article presents the results from analyzing medical professional liability claims from the obstetrics-gynecology department in a Level III University Hospital in Italy filed between 01.01.2003 and 31.12.2019.

Results: Out of 130 total claims filed, 78 derive from the obstetrics department and 52 from gynecology. In obstetrics, 25 cases pertain to vaginal delivery and 27 to cesarean sections. In gynecology, 37 cases pertained to the diagnosis or treatment of diseases affecting the female genital system, 15 to omitted or missed prenatal diagnosis of fetal malformations, 11 to the pregnancy or postpartum period, 12 to pregnancy termination, and 3 to artificial insemination. In the obstetrics-gynecology area, 40% of these compensation claims were accepted. This is higher than the average overall percentage of claims documented in the medico-legal watchdog database during the same time period, which was 33%. The acceptance rate for claims deriving from the obstetrics department was 25%, while the acceptance rate for complaints filed in the gynecology department was 57%.

Discussion: Obstetrics and gynecology represent a high-risk sector for medico-legal litigation with a greater percentage of accepted compensation claims than the general case study data. In the obstetrics field, there is a high frequency of claims for damages incurred during cesarean sections, even though the injuries claimed are mainly connected to the overall surgical procedure. The gynecological area also has a greater rate of compensation claims accepted by Medico-Legal Services, making this an area of particular interest for prevention. 

Conclusions: The implementation of a dedicated medico-legal watchdog on professional liability serves to prevent and lower compensation rates through the analysis of claims from this high-risk area.