Risk Factors and Liability Distribution in Medical Disputes Related to Spinal Diseases: A Six-Year Retrospective Study in Beijing.

PURPOSE: To summarize the characteristics and liability distribution of medical disputes related to spinal diseases in Beijing and to identify factors associated with major harm and liability allocation.

METHODS

We retrospectively analyzed 180 spine-related dispute cases obtained from the Beijing Medical Dispute Mediation Committee (January 2015-December 2020). We extracted information on outcomes, liability allocation, and potential risk factors, and performed descriptive and regression analyses.

RESULTS

The main adverse events leading to disputes were misdiagnosis/mistreatment (61 cases, 33.9%), surgical/operation errors (54 cases, 30.0%), infection (13 cases, 7.2%), new neurologic deficit (13 cases, 7.2%), and insufficient symptom relief (10 cases, 5.6%). Additionally, 29 cases (16.1%) were determined as disease/treatment itself. Physicians were primarily liable in 116 cases (64.4%), and major patient harm occurred in 33 cases (18.3%). Major harm was associated with misdiagnosis/mistreatment (univariate analysis, P=0.006; multivariate analysis, OR= 3.281, 95% CI 1.359-7.918, P=0.008), emergency (univariate analysis, P=0.020; multivariate analysis, OR=13.446, 95% CI 1.042-173.422, P=0.046), and treatment during holidays (univariate analysis, P=0.035; multivariate analysis, OR=4.125, 95% CI 1.182-14.399, P=0.026). Liability distribution for misdiagnosis/mistreatment was unfavorable to the doctors (univariate analysis, P=0.028; multivariate analysis, OR=2.144, 95% CI 1.071-4.291, P=0.031). Overall, 116 cases (64.4%) were resolved through mediation, with an actual average compensation amount of 220,272.72 RMB (range 5,000-2,381,523 RMB).

CONCLUSION

This study characterizes the clinical features, liability distribution, and factors associated with major harm in spine-related medical disputes handled through formal mediation in Beijing. The findings provide region-specific evidence that may support targeted quality improvement, clinical risk management, and dispute-prevention strategies in spine care.