Litigation in cardiology and cardiovascular surgery: A cross-sectional observational study of liability in the Spanish public healthcare system

Abstract

IntroductionThe overestimation by physicians of the risk of a lawsuit has, among other consequences, the stepped-up of defensive medicine. To analyse the characteristics of medical liability rulings in Spain in public health care in the specialties of cardiology and cardiovascular surgery. Materials and methodsCross-sectional observational study analysing the rulings handed down in the contentious-administrative jurisdiction by the High Courts of Justice in the period 2008–2020, in the specialties of cardiology and cardiovascular surgery. The variables were administrative, clinical, judicial, and compensatory. ResultsA total of 1015 rulings were analysed; 47 (4.63%) involved to the specialties of cardiology and cardiovascular surgery. Both obtained similar frequency percentages, cardiology 22 (2.2%) and cardiovascular surgery 25 (2.5%). A total of 74.1% of the rulings were dismissed in the first instance and 75% in the second instance. The 2 grounds for finding against the defendent were loss of chance 6 (42.85%) and diagnostic and/or therapeutic malpractice 5 (35.71%). Damages were usually claimed: death 21 (44.68%) and sequelae 26 (55.32%). The median award was 30 000 euros. ConclusionsThe low frequency of claims in cardiology and cardiovascular surgery indicates that these are "low risk" specialties for litigation. The vast majority of the rulings are, moreover, dismissive of the patients' claims. The data help to structure the role of lawsuits and to increase professionals' knowledge of the medical–legal dimension of health care.