Epidemiology of medico-legal litigations and related medical errors in Central and Northern Saudi Arabia. A retrospective prevalence study

OBJECTIVE: 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.

METHODS: 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.

RESULTS: The patient's mean age was 29.5 years. Fifty-seven 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).

CONCLUSION: 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.