The Analysis of Medical Malpractice Litigation Related to Diagnosis of Headache in Japan: Mitigating Medicolegal Risks for Primary Care Physicians.

BACKGROUND

Malpractice disputes are a major problem for physicians. Headache is one of the most common symptoms seen in medical settings, and therefore often an issue in malpractice cases. Little is known about the characteristics of headache in cases that end up as malpractice suits.

METHODS

This study reviews all civil lawsuits involving headache that were identified in a Japanese database of lawsuits (Westlaw Japan). This study examined the basic characteristics, main issues, and results in each case, as well as the features of headaches, including clinical characteristics for secondary headaches and "red flags" identified by the court.

RESULTS

In total, 2,906 cases were examined, of which 48 headache-related negligence lawsuits were retained for analysis. Judgments in these cases were delivered between January 2001 and November 2022. All 48 cases involved issues related to the diagnosis or treatment of headaches. Six cases were excluded because they were judgments from appeal courts or the Supreme Court, and judgments from lower courts in these cases were already included. Overall, 35 cases involved issues related to the diagnosis of headaches. No statistically significant differences were found between cases with and without negligence in terms of basic characteristics and the prevalence of red flags.

CONCLUSIONS

This study examined the basic characteristics of medical malpractice lawsuits related to the diagnosis and treatment of headache in Japan. No available features for avoiding medical malpractice and legal negligence were found. Even when no obvious red flags of secondary headache are identified, diagnostic errors could still lead to findings of negligence in malpractice claims.