Analysis of current trends in emergency medicine malpractice claims in Japan

Background and Purpose: In recent years, malpractice litigations have steadily increased across all medical specialties. Claims arising from incidents in the emergency department are increasing as well, where a shortage of physicians is perceived as a high malpractice risk. An analysis of claims filed against emergency physicians has revealed certain disease process and case characteristics. In this study, we retrospectively analyzed the characteristics of medical malpractice claims stemming from emergency care.<BR>Methods: This was a retrospective review of all Emergency Medicine malpractice claims filed between 1965 and 2011. The keywords used to search the databases of TKC Law Library and D1-Law.com were “medical lawsuit”, “medical malpractice”, “emergency outpatient department”, and “emergency medical center”. Results showed that emergency physicians were the primary defendants in 50 complaints made regarding emergency medical procedures. Variables such as diagnosis, claimant age, claimant sex, medical issue, clinical outcome, indemnity payment claimed by plaintiff, indemnity payment awarded to plaintiff, plaintiff’s claim, and legal outcome were analyzed.<BR>Results: Characteristics of patients revealed that 80% (40/50) were men and 20% (10/50) were women whose average age was 46 (range, 8-84). Twelve percent of cases (6/50) involved adolescents under age 15. The disease processes associated with the highest number of claims included traumatic injury (11 deaths), ileus (6 deaths, 1 postsurgical sequela), acute epiglottitis (3 deaths, 3 severe brain dysfunction), subarachnoid hemorrhage (3 deaths, 1 severe brain dysfunction), acute myocardial infarction (3 deaths), and acute aortic dissection (3 deaths). Indemnity was paid in 76% of cases. Excluding the 12 dismissed cases, the average indemnity payment was 39.11 million yen, and over 100 million yen was settled in four cases.<BR>Conclusion: Medical conditions associated with the highest number of malpractice claims are traumatic injury, subarachnoid hemorrhage, acute aortic dissection, epiglottitis and ileus. In any case, a misdiagnosis is all the biggest problem.