Autopsy study of 275 medical dispute cases

Abstract

To study the characteristics of autopsies in medical dispute cases, with respect to class of hospitals, clinical units concerned, age of deceased and cause of death. Two hundred and seventy-five autopsies performed on medical dispute cases during the period from January 1, 2002 to September 30, 2008 at the Department of Pathology, Health Science Center, Peking University, China were retrospectively reviewed. During the period of study, the number of autopsies performed on medical dispute cases gradually increased. Medical dispute cases happened more often in surgical, obstetric and gynecology departments of grade II and III hospitals, as well as emergency departments of grade I hospitals. Perinatal death in infants of less than 1 year old more frequently caused medical dispute than death occurring in other age groups. According to the International Classification of Diseases (ICD10), disorders of the circulatory system, perinatal illnesses, external injury or iatrogenic conditions represented the major categories of cause of death. In general, the vast majority was due to natural causes and only 13.5% were related to iatrogenic reasons or medical negligence. Pathologic diagnosis of sudden coronary death, myocardial infarction and viral myocarditis should only be made with strict diagnostic criteria. Autopsies for medical dispute cases can help to delineate the cause of death and provide evidence for further clarification. Meticulous autopsy techniques, application of strict diagnostic criteria and detailed analysis of cause of death are key steps in achieving a high quality service in this area.