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The medico-legal autopsy is an essential tool in investigating deaths caused by an adverse event in health care, for both clinical risk management and for professional liability issues. However, there are no statistics available regarding the frequency of autopsies performed due to suspected adverse events. This study aimed to determine the number of medico-legal autopsies done because of presumed adverse events, whether these events were unintentional, medical errors or cases in which malpractice was suspected. Furthermore, differences in treatment types, causes and manner of death were analyzed. The data was obtained from all medico-legal autopsies performed in Northern Finland and Lapland during 2014–2015 (n = 2027). Adverse events were suspected in 181 (8.9%) cases. The suspicions of an adverse event occurring were most often related to medication, gastrointestinal surgery and orthopedic surgery. The manner of death was classified as medical (or surgical) treatment or investigative procedure in 22 (12.2%) cases. The causes of death were completely unrelated to the suspected adverse event in 41 (22.7%) cases. In conclusion, the frequency of presumed adverse events was quite high in this data set, but in the majority of the cases, the suspicion of an adverse event causing death was disproved by an autopsy. Nonetheless, proper investigation of these cases is essential to ensure legal protection of the deceased, next of kin and health care personnel, as well as to support clinical risk management.
Ferrara SD. Medical malpractice and legal medicine. Int J Legal Med. 2013;127:541–3. CrossRef
Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington D.C: National Academy Press; 2000.
Pasternack A. Hoitovirheet ja hoidon aiheuttamat haitat. Duodecim. 2006;122:2459–70. PubMed
Terveyden ja hyvinvoinnin laitos. Potilasturvallisuutta taidolla –ohjelma. Helsinki: Terveyden ja hyvinvoinnin laitos; 2011.
Madea B, Preuß J. Medical malpractice as reflected by the forensic evaluation of 4450 autopsies. Forensic Sci Int. 2009;190:58–66. CrossRef
Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016;353:i2139. CrossRef
Gay JG, Paris V, Devaux M, de Looper M. Mortality amenable to health care in 31 OECD countries: estimates and methodological issues. OECD health working papers, no. 55. Paris: OECD Publishing; 2011.
Manderbacka K, Sund R, Ruuth I, Sajantila A, Arffman M, Milén A, et al. How should deaths connected to misadventures in health care be identified? Suom Lääkäril. 2012;67:789–93.
Madea B. Medical malpractice. In: Madea B, editor. Handbook of forensic medicine. Chichester: Wiley Blackwell; 2014. p. 545–61. CrossRef
Madea B. Medico-legal autopsies as a source of information to improve patient safety. Legal Med. 2009;11(Suppl 1):S76–9. CrossRef
Ferrara SD, Baccino E, Bajanowski T, Boscolo-Berto R, Castellano M, De Angel R, et al. Malpractice and medical liability. European guidelines on methods of ascertainment and criteria of evaluation. Int J Legal Med. 2013;127:545–57. CrossRef
Bove KE, Iery C; Autopsy committee, College of American Pathologists. The role of the autopsy in medical malpractice cases, I: a review of 99 appeals court decisions. Arch Pathol Lab Med. 2002;126:1023–31.
Anderson JG, Abrahamson K. Your health care may kill you: medical errors. In: Lau F, Bartle-Clar J, Bliss G, Borycki E, Courtney K, Kuo A, editors. Building capacity for health informatics in the future. Amsterdam: IOS Press; 2017. p. 13–7.
World Health Organization. International statistical classification of diseases and related health problems, 10th revision, edition 2010. Geneva: WHO Press; 2011.
Flaatten H, Brattebø G, Alme B, Berge K, Rosland JH, Viste A, et al. Adverse events and in-hospital mortality: an analysis of all deaths in a Norwegian health trust during 2011. BMC Health Serv Res. 2017;17:465. CrossRef
Madea B, Musshoff F, Preuss J. Medical negligence in drug associated deaths. Forensic Sci Int. 2009;190:67–73. CrossRef
Potilasvakuutuskeskus. Vuosiraportti 2018. Potilasvakuutuskeskukselle ilmoitetut tapaukset ratkaisuvuosittain vuosilta 2013–2018. Potilasvakuutuskeskus: Helsinki. p. 2019.
Saukko P. Medicolegal investigative system and sudden death in Scandinavia. Nihon Hoigaku Zasshi. 1995;49:458–65. PubMed
Terveyden ja hyvinvoinnin laitos. Oikeuslääkinnän kehittämissuunnitelma vuosille 2010–2015. Helsinki: Terveyden ja hyvinvoinnin laitos; 2011.
- Presumed adverse events in health care are a frequent indication for medico-legal autopsy in Finland
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Forensic Science, Medicine and Pathology
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