An evaluation of medical negligence cases: Role and contribution of medico-legal autopsy

Abstract

Autopsy based forensic evaluations are critical to the final outcome of medical negligence cases. It is imperative that autopsy surgeon is aware of clinical issues and should plan autopsy dissection with respect to those issues. This study is aimed to determine the role of medico-legal autopsy in the ascertainment, assessment and evaluation of the medical negligence cases. In this retrospective study, total 61 medico-legal autopsy cases involving medical negligence claims were studied. Cases were classified according to type of health care facility, type of medical or surgical specialty as well as discrepancies between clinical and autopsy diagnosis and type of medical error involved. Surgical branches (82%) are more involved in alleged medical negligence cases than medical branches (18%). 33% cases are of Obstetrics & Gynecology followed by Anesthesia (29%), and Surgery (20%). In majority of cases (65%), small private hospitals with less than 100 beds (type C) are involved. Act of commission was found in 26% cases. Act of omission was claimed in 7%. In 18% cases there was a failure to diagnose major disease in pre-anesthetic and pre-operative check up. In 8% cases wrong diagnosis was claimed. In one case, nursing staff has given wrong drug to the child led to the sudden death. In 13% cases death occurred due to known complications. Present work indicates that early post-mortem examination in alleged medical negligence cases provides new and unrecognized information of great assistance in determining the cause of death.