title: An analysis of closed medical litigations against the obstetrics departments in Taiwan from 2003 to 2012†.
abstract: OBJECTIVE
  To examine the epidemiologic data of closed medical claims from Taiwanese civil courts against obstetric departments and identify high-risk diseases.
  
  
  METHODS
  A retrospective descriptive study.
  The verdicts from the national database of the Taiwan judicial system that pertained to obstetric departments were reviewed. Between 2003 and 2012, a total of 79 closed medical claims were included.
  
  
  METHODS
  The epidemiologic data of litigations including the results of adjudication and the disease and outcome of the alleged injury.
  
  
  RESULTS
  A majority of the disputes (65.9%) were fetus-related. Four disease categories accounted for 78.5% of all claims including (i) perinatal maternal complications (25.3%); (ii) errors in antenatal screening or ultrasound diagnoses (21.5%); (iii) fetal hypoxemic-ischemia encephalopathy (16.5%); and (iv) brachial plexus injury (15.2%). Six cases (7.6%) resulted in an indemnity payment with a mean amount of $109 205. Fifty-one cases (64.6%) were closed in the district court. The mean incident-to-litigation closure time was 52.9 ± 29.3 months. All cases with indemnity payments were deemed negligent or were at least determined to be controversial by a medical appraisal, while all defendants whose care was judged as appropriate by a medical appraisal won their lawsuits.
  
  
  CONCLUSIONS
  Almost 93% of clinicians win their cases but spend 4.5 years waiting for final adjudication. The court ruled against the clinician only if there was no appropriate response during a complication or if there was no follow-up or further testing for potential critical diseases.
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Kuan-Han
authors.initials: KH
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Hsien-Hung
authors.initials: HH
authors.lastname: Cheng
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Fu-Jen
authors.initials: FJ
authors.lastname: Cheng
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Pai-Chun
authors.initials: PC
authors.lastname: Yen
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Yung-Lin
authors.initials: YL
authors.lastname: Yen
authors.affiliation: Department of Gynecology and Obstetrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Township, Kaohsiung County 833, Taiwan.
authors.forename: Te-Yao
authors.initials: TY
authors.lastname: Hsu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence*; D009775:Obstetrics and Gynecology Department, Hospital / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D012189:Retrospective Studies; D013624:Taiwan
keywords: closed-claims analysis; medical error; medical litigation; obstetrics