IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0312614.html

Analysis of medico-legal claims related to deliveries: Caesarean section vs. vaginal delivery

Author

Listed:
  • Nasim Eshraghi
  • Marjan Ghaemi
  • Zahra Shabannejad
  • Elham Bazmi
  • Mehdi Foroozesh
  • Mohammad Haddadi
  • Sepideh Azizi
  • Zeinab Mansouri
  • Sedigheh Hantoushzadeh

Abstract

Background: The Iranian National Health Service (NHS) suggested that gynecologists face a higher risk of medicolegal claims, with a significant number of claims being related to delivery events. This study aimed to investigate the factors associated with delivery related claims. Method: In this cross-sectional study, we conducted an analysis of medico-legal documents which related to complications during delivery events and presented to Iranian Medical Legal Organization spanning from March 2018 to February 2020. A total of 227 legal prosecutions that were initiated by patients or, in cases where that wasn’t possible, by their families, were included in the study and all of them were evaluated in commission with experienced professionals. The data collection phase occurred between February 2023 and May 2023. The collected data encompassed various aspects, including patient characteristics mode of delivery, reasons for claims, hospital type, accused party, the occurrence of instrumental delivery and the final disposition of the claims (paid claims or closed claims). Paid claims represent successful lawsuits where the healthcare provider or their insurer made a financial settlement to the patient. Closed claims encompass those that were either denied or dismissed. Chi-square or t-tests were employed to compare factors between paid claims and closed claims. Result: In this study, it was observed that vaginal delivery was performed in 51.1% of the claims, whereas 48.9% underwent a caesarean section.. Approximately half of the claims were against obstetrician-gynecologists, and 33% of the claims against other providers were against midwives.. The majority of complaints were related to perinatal mortality (34.8%) and neonatal asphyxia (18.5%). In 58.1% of cases, no malpractice was identified, while 41.9% resulted in paid claims. Also, there were no significant differences between the paid claims and closed claims groups in several factors, such as the type of hospital (P = 0.904), maternal age (P = 0.157), type of delivery (P = 0.080), and accused party (P = 0.168). However, the number of instrumental deliveries (13.8% of vaginal deliveries) and the reasons for claims, exhibited significant differences between the two claims (P = 0.021, P

Suggested Citation

  • Nasim Eshraghi & Marjan Ghaemi & Zahra Shabannejad & Elham Bazmi & Mehdi Foroozesh & Mohammad Haddadi & Sepideh Azizi & Zeinab Mansouri & Sedigheh Hantoushzadeh, 2024. "Analysis of medico-legal claims related to deliveries: Caesarean section vs. vaginal delivery," PLOS ONE, Public Library of Science, vol. 19(11), pages 1-11, November.
    • Handle: RePEc:plo:pone00:0312614
    DOI: 10.1371/journal.pone.0312614
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0312614
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0312614&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0312614?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Elad Asher & Shay Dvir & Daniel S Seidman & Sari Greenberg-Dotan & Alon Kedem & Boaz Sheizaf & Haim Reuveni, 2013. "Defensive Medicine among Obstetricians and Gynecologists in Tertiary Hospitals," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-5, March.
    2. Beomsoo Kim, 2007. "The Impact of Malpractice Risk on the Use of Obstetrics Procedures," The Journal of Legal Studies, University of Chicago Press, vol. 36(S2), pages 79-119, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Xin Zhao & Xiaoxue Li & Benno Torgler & Uwe Dulleck, 2021. "Patient violence, physicians treatment decisions, and patient welfare: Evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1461-1479, June.
    2. Scott Barkowski, 2017. "Does Regulation of Physicians Reduce Health Care Spending?," Southern Economic Journal, John Wiley & Sons, vol. 83(4), pages 1074-1097, April.
    3. Morita, Hatsuru, 2018. "Criminal prosecution and physician supply," International Review of Law and Economics, Elsevier, vol. 55(C), pages 1-11.
    4. Andrew Friedson & Thomas Kniesner, 2012. "Losers and losers: Some demographics of medical malpractice tort reforms," Journal of Risk and Uncertainty, Springer, vol. 45(2), pages 115-133, October.
    5. Annalisa Scognamiglio, 2019. "Cesarean sections: Use or abuse?," CSEF Working Papers 534, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    6. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    7. Daniel P. Kessler, 2011. "Evaluating the Medical Malpractice System and Options for Reform," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 93-110, Spring.
    8. Chopard, Bertrand & Musy, Olivier, 2023. "Market for artificial intelligence in health care and compensation for medical errors," International Review of Law and Economics, Elsevier, vol. 75(C).
    9. Chopard, Bertrand, 2025. "Liability law, Defensive medicine and Healthcare quality," International Review of Law and Economics, Elsevier, vol. 84(C).
    10. Beomsoo Kim, 2010. "Do Doctors Induce Demand?," Pacific Economic Review, Wiley Blackwell, vol. 15(4), pages 554-575, October.
    11. Ihsan Solaroglu & Yusuf Izci & H Gokce Yeter & M Mert Metin & G Evren Keles, 2014. "Health Transformation Project and Defensive Medicine Practice among Neurosurgeons in Turkey," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-7, October.
    12. Paola Bertoli & Veronica Grembi, 2018. "Medical Malpractice: How Legal Liability Affects Medical Decisions," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 235-261, Emerald Group Publishing Limited.
    13. Javier Cano-Urbina & Daniel Montanera, 2017. "Do tort reforms impact the incidence of birth by cesarean section? A reassessment," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 103-112, March.
    14. Stoddard Christiana & Stock Wendy A. & Hogenson Elise, 2016. "The Impact of Maternity Leave Laws on Cesarean Delivery," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 16(1), pages 321-364, January.
    15. Toshiaki Iizuka, 2013. "Does Higher Malpractice Pressure Deter Medical Errors?," Journal of Law and Economics, University of Chicago Press, vol. 56(1), pages 161-188.
    16. Cotet-Grecu, Anca, 2015. "The impact of non-economic damages caps on obstetrics: Incentives versus practice style," Economics & Human Biology, Elsevier, vol. 17(C), pages 29-41.
    17. Sloan, Frank A. & Shadle, John H., 2009. "Is there empirical evidence for "Defensive Medicine"? A reassessment," Journal of Health Economics, Elsevier, vol. 28(2), pages 481-491, March.
    18. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    19. Ity Shurtz, 2014. "Malpractice Law, Physicians' Financial Incentives, and Medical Treatment: How Do They Interact?," Journal of Law and Economics, University of Chicago Press, vol. 57(1), pages 1-29.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0312614. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.