Status of medical Liability ClaimsStatus of medical Liability ClaimsIn Saudi ArabiaIn Saudi Arabia
Prof. Abdulhamid Samarkandi, Prof. Abdulhamid Samarkandi, FFARCSIFFARCSIAnaesthesia Department, King Saud University
Chairman, Saudi Anaesthetic Association
Member of the Medico-Legal Committee, Riyadh Region
Scope of the Problem
Evolution in Health Care Services
- Upgrading Technology
- Training & Gained experience of Medical staff
Increased number of Medical Claims
- ↑ Population Census
- ↑ Awareness about Health matters
Handling of the Problem
Formulate and to set standards and regulations that determine the responsibilities of health
care providers ( Facility/ Physicians )
towards patients
Regulation for the Practice of Medicine & Dentistry
Enacted by the Royal Decree ( 1409 Hijri )
Determine Responsibility of Medical practitioners
Regulate Patient-Doctor relationship
The Medico-legal Committee
Members: Judge Ministry of Justice
Doctors 2 members
- Ministry of Health
- Teaching University Staff
Medico-Legal Committee
Role:
Carries the responsibility of receiving claims and investigating the professional malpractice that resulted in either morbidity or
mortality
Number & Locations: 8 Subcommittees,
Covering various regions of KSA
Process of Medical Litigation A Claim from the patient or his/her Representative towards a
medical malpractice ( from his view ) The Claim directed either to MOH or City government Investigation within the medical facility encountered in claim The MLC then assigned to follow with a process of thorough
review of all documents and medical filling together with interviewing both sides of the claim- the plaintiff and defendant
Reach a Final Decision of accusation or clearance from the claim according to the “Regulations of Medical Practice“ which is based on . Professional aspects . Governed by Islamic Shariaah law
Professional liability
The Civil liability: المدنية المسئولية This is the responsibility of a physician towards the
patient when harm being inflicted as a result of direct action against medical rules from the physician or proven negligence.
The Punitive liability: الجزائيـة المسئولية That deals with physicians who violate the rules and
regulations of medical practice even with no subsequent harm resulted to the patient.
The Disciplinary liability: التأديبية المسئولية Where a physician failed to meet with professional
standards, requirements and ethics .
Final Decision ( Verdict )I - Clearance from the claimII - Accusation - Warning - Financial Compensation - Prohibiting medical practice - Medical License withdrawal - Imprisonment
Data Analysis
Studied Period 5 years ( 1420 H – 1424 H ) / ( 1999 – 2003 )
Retrospective Analysis of Raw Data Official documentation of the MLC
Aim of the Work
Incidence of Claims towardsI- Study period of analysis
II- Medical Specialty
III- Sector of Health Care Facility
IV- Geographical Distribution over KSA
The Trend of the total number of claims in The Trend of the total number of claims in different medical specialtiesdifferent medical specialties
The percentage of claims in different The percentage of claims in different Medical SpecialtiesMedical Specialties
Sectors of the Medical Health Care serviceSectors of the Medical Health Care service
1420 1421 1422 1423 1424
Ministry of HealthMedical Services
111 100 123 188 188
Private SectorMedical Services
124 123 123 169 144
MilitaryMedical Services
16 13 14 17 12
UniversityMedical Services
5 1 6 6 3
OtherMedical Services
9 18 5 13 6
Distribution of the Convicted decisions over Distribution of the Convicted decisions over Saudi Arabia different RegionsSaudi Arabia different Regions
1420 1421 1422 1423 1424
Riyadh 88 67 47 48 54
Makka Al- Mokkarama 11 31 39 65 37
Eastern Region 29 25 44 31 34
Madina Al- Monawara 33 27 11 42 13
Aseer 30 14 23 24 36
Qassim 12 22 12 12 21
Holy Capital --- --- --- 53 61
Ehsaa --- --- --- 10 14
Anaesthetist Shared responsibility with Obstetrician for:1- Not checking blood availability or even reserving2- NO Intraoperative Anaesthesia Record of management
Female P 11+1 for Emergency CS ( Breech Presentation )
INCIDENT: Intractable Intraoperative Hge. NO Blood Available 6 hrs postoperatively Mortality follows
• Female P 2+7,39yrs
• 1st alive baby ,3intra-ut.death,
• 5th C.S baby dead,6th alive
• 7th stated Bl.transfusion from 18 week
• Resident wrote: Diazpam 20mg orally
Pancronium 4mg I.V
To be given 1 hr before transfusion
The mother given I.V pancronium the nurse came to take her to U.S after 50 min she was DEAD
Recommendations &
Personal Advice
No Minor Anaesthetic procedure Assess your Patient Thoroughly & ask for advice in case you need Share the Patient & Relatives in Plan of treatment Estimate accurately the Risk and discuss it with the patient Clear informed Consent Clear Documentation of every detail in date & time Update your Professional Knowledge Encourage Educational Activities ( Audits, M&Ms,….etc) In case encountered in an INCIDENT ( Subject for Interrogation ) - Review the whole case filling & records - Quote relevant literature - Provide testimony in writing highlighting specific events
When you are certain that the consequences When you are certain that the consequences of an error is disastrousof an error is disastrous
……so it is of logic to be too carefulso it is of logic to be too careful
No one is immune against pitfalls and mishaps, No one is immune against pitfalls and mishaps, so let us pray to Allah to provide us so let us pray to Allah to provide us
with his protection and mercywith his protection and mercy and give us the strength and ability and give us the strength and ability
to serve our patientsto serve our patients
To Whom They To Whom They ComplaintComplaint
Thank youThank you