Abstract
The medico-legal autopsy is an essential tool in investigating deaths caused by an adverse event in health care, for both clinical risk management and for professional liability issues. However, there are no statistics available regarding the frequency of autopsies performed due to suspected adverse events. This study aimed to determine the number of medico-legal autopsies done because of presumed adverse events, whether these events were unintentional, medical errors or cases in which malpractice was suspected. Furthermore, differences in treatment types, causes and manner of death were analyzed. The data was obtained from all medico-legal autopsies performed in Northern Finland and Lapland during 2014–2015 (n = 2027). Adverse events were suspected in 181 (8.9%) cases. The suspicions of an adverse event occurring were most often related to medication, gastrointestinal surgery and orthopedic surgery. The manner of death was classified as medical (or surgical) treatment or investigative procedure in 22 (12.2%) cases. The causes of death were completely unrelated to the suspected adverse event in 41 (22.7%) cases. In conclusion, the frequency of presumed adverse events was quite high in this data set, but in the majority of the cases, the suspicion of an adverse event causing death was disproved by an autopsy. Nonetheless, proper investigation of these cases is essential to ensure legal protection of the deceased, next of kin and health care personnel, as well as to support clinical risk management.
Highlights
Mortality related to health care is a major concern considering patient safety and the quality of treatment
Deaths caused by health care can be divided into adverse events, preventable adverse events and negligent adverse events [9]
Data was gathered from autopsy reports, death certificates and police reports related to medico-legal autopsies carried out in the National Institute for Health and Welfare, Oulu, Finland, during 2014–2015
Summary
Mortality related to health care is a major concern considering patient safety and the quality of treatment. The importance of this topic has grown constantly as a result of public awareness and expectations towards medical science [1]. There are no exact statistics available about treatment-related mortality or the number of deaths in which an adverse event or error are suspected. Deaths caused by health care can be divided into (unpreventable) adverse events, preventable adverse events and negligent adverse events (malpractice) [9]. Adverse events are caused by unintended reactions to treatment, for example, a medication-related reaction or an unavoidable post-surgical infection. A preventable adverse event can be related to human or system factors. Malpractice is caused by neglect, either intentional or unintentional, by personnel involved in the duty of care
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