The risk of malpractice litigation in care to head-injury patients in comparison with other high-risk patient groups: an inpatient-based epidemiological study in Taiwan.

BACKGROUND

The purpose of this study was to assess the risk of being sued in district courts for care for head-injury patients from the perspective of epidemiology.

METHODS

This research was designed to be a retrospective population-based cohort study. We researched the incidences of litigations arising from head-injury inpatients under neurosurgical care, all neurosurgical inpatients, and birth inpatients in Taiwan, and computed their relative risks. The study period was from 1998 to 2002.

RESULTS

The average annual incidence rate of becoming a plaintiff for head-injury neurosurgical inpatients was 15 per million; for all neurosurgical inpatients 11.8 per million; and for birth patients 33.5 per million. The relative risk comparing head-injured neurosurgical inpatients against all neurosurgical inpatients was 1.27; whereas comparing head-injury neurosurgical inpatients against birth inpatients was 0.45, and comparing all neurosurgical inpatients against birth inpatients, 0.35.

CONCLUSIONS

The findings of our population-based study indicate that for the inpatient populations, whether head-injury patients or not, neurosurgeons in Taiwan are facing a relatively lower rate of litigation in comparison with those treating birth patients. Nonetheless, head-injury patients still pose a major challenge in the ED, and misdiagnosis remains the major complaint of plaintiffs in subsequent litigations.