Study ID
|
Study design
|
Database
|
Country
|
Sample size
|
Sex Female %
|
Age (mean)
|
Area of the intervention
|
Evaluating disorder
|
Key findings
|
Swonke 2020
[27]
|
Cohort
|
Westlaw
|
USA
|
55
|
90.91
|
45.5
|
General surgery, Otolaryngology
|
Thyroidectomy
|
Recurrent laryngeal nerve injury was the most common complication leading to trial, with most cases ruling in favor of the defense
|
Myers 2020
[15]
|
Cohort
|
Comparative Benchmarking System
|
USA
|
1,113
|
61.1
|
54
|
Intensive care unit
|
Patient assessment, selection/management of therapies, and communication among providers
|
There were a few unexpected differences in malpractice claims occurring in the ICU by physician specialty
|
Sabry 2019
[28]
|
Cohort
|
Kasr El-Aini Hospital records
|
Egypt
|
220
|
33
|
54.5
|
Intensive care unit
|
Medication
|
Medication errors in critical care are frequent, severe, and predictable
|
De Ravin 2022
[29]
|
Cohort
|
Westlaw
|
USA
|
61
|
36
|
__
|
Surgery
|
Robotics
|
Malpractice litigation in robot-assisted surgery is infrequent. As robotic procedures become more commonplace, surgeons must consider joint liabilities
|
Chen 2023
[30]
|
Cohort
|
China Judgments Online
|
China
|
109
|
24
|
62
|
Cardiothoracic surgery
|
Coronary artery bypass grafting
|
The diagnosis and treatment capabilities of coronary artery bypass grafting in different levels of hospitals in China were inconsistent, and the treatment capabilities in prefecture-level hospitals were lower than those in national hospitals
|
Hwang 2019
[25]
|
Cohort
|
Westlaw
|
USA
|
242
|
47
|
35
|
Oncology
|
Sarcoma Litigation
|
Many lawsuits were made against primary care physicians, nononcology-trained orthopedic surgeons, or radiologists for a delayed diagnosis of sarcoma despite the presence of imaging or histologic findings suspicious of malignancy
|
Agarwal 2018
[31]
|
Cohort
|
Westlaw
|
USA
|
98
|
45
|
52
|
Surgery
|
Spine
|
Overall, physicians were not found liable in the majority of spine surgery malpractice cases queried
|
Ahmed 2019
[32]
|
Cohort
|
VerdictSearch
|
USA
|
201
|
81
|
43.1
|
Orthopedic
|
Traumatic Fracture
|
In cases with decisions for the plaintiff, indemnity payments were, on average, more than $2.5 million larger than payments for settlements
|
Alagha 2011
[33]
|
Cohort
|
Ain Shams University hospital records
|
Egypt
|
240
|
|
43
|
Pediatric
|
Medication
|
Clinical pharmacists’ activities, focusing on improving physician-nurse communication, physician drug knowledge, and awareness of errors, were shown effective in reducing the rate of prescribing errors and their potential severity in a PICU
|
Ali 2017
[34]
|
Cohort
|
Hospital records
|
Egypt
|
150
|
27.7
|
58.3
|
Cardiology
|
Acute coronary syndrome
|
Dosing errors, omission of essential drugs, and monitoring errors were
most common error types encountered
|
Al-Jeraisy 2011
[35]
|
Cohort
|
King Abdulaziz Medical City records
|
Saudi Arabia
|
1333
|
35
|
6.5
|
Pediatric
|
Medication
|
The incidence of medication prescribing errors was significantly high. Large-scale prospective studies are recommended to determine the extent and outcome of medication errors in pediatric hospitals in Saudi Arabia
|
Al Khaja 2007
[36]
|
Cohort
|
Primary Care Health centers records
|
Bahrain
|
2282
|
48.5
|
6.5
|
Pediatric
|
medication
|
Irrational drug therapy in infants, with prescribing errors apparent in primary care practice, which may be related to a lack of drug
information
|
Samarkandi 2006
[37]
|
Cohort
|
National Medico-Legal Committee
|
Saudi Arabia
|
1537
|
_
|
_
|
_
|
_
|
Professional liability as an entity covers three different aspects: civil, punitive, and disciplinary liability
|
Kim 2020
[38]
|
Cohort
|
Supreme Court of Korea’s written judgment management system
|
Korea
|
25
|
7
|
43
|
General surgery
|
necrotizing fasciitis
|
The timely recognition and management of Necrotizing fasciitis might be considered one of the main factors for deciding malpractice in court
|
Badger 2007
[39]
|
Cohort
|
Medical Liability Mutual Insurance Company of New York State
|
USA
|
469
|
_
|
_
|
Urology
|
Cancer
|
Malpractice claims of missed diagnoses against urologists, resulting in indemnity payment to evaluate causes and identify opportunities for prevention
|
Badger 2018
[40]
|
Cohort
|
Westlaw
|
USA
|
55
|
64.3
|
45.9
|
Otolaryngology
|
dysphagia
|
The majority of these cases are decided in favor of the defendant; the cost of a negative outcome is considerable
|
Beez 2018
[26]
|
Cohort
|
review board of the North Rhine Medical Council
|
Germany
|
391
|
_
|
12
|
Pediatric Neurosurgery
|
Adverse events
|
A high-risk specialty's malpractice claim rate is lower than expected. Adverse events were confirmed in all cases; a negligent medical error was rare
|
Carroll 2015
[41]
|
Cohort
|
(1) NPDB, (2) Jury Verdict Research (JVR), and (3) Physician Insurers As- sociation of America (PIAA)
|
India
|
214 226
|
_
|
_
|
Pediatric
|
Payment
|
Malpractice is a serious issue. Some will read the results of this analysis and draw comfort; others will view the same data with alarm and surprise
|
Otaki 2017
[42]
|
Cohort
|
Sompo Japan Nipponkoa Incorporated
|
Japan
|
38
|
63
|
54.7
|
Rheumatology
|
Rheumatoid Arthritis
|
The characteristics of malpractice claims associated with RAmanagement, including the high frequency of medication-related
allegations, breakdowns in the assessment process, and high claim numbers among patients
|
Patel 2019
[43]
|
Cohort
|
Westlaw
|
USA
|
166
|
68
|
52.48
|
Cardiology
|
Defensive medicine
|
increased training for non-cardiologists in the recognition of acute coronary
|
Custer 2017
[44]
|
Cohort
|
Westlaw
|
USA
|
167
|
44.1
|
41.9
|
Ophthalmology
|
Refractive Surgery
|
Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff
|
Dawson 2007
[45]
|
Cohort
|
Physician Insurers Association of America, Risk Management Report
|
USA
|
213,994
|
_
|
_
|
Rhinology
|
Endoscopic sinus surgery
|
Despite malpractice being a cost of medical practice, every claim is perceived as an assault on the surgeon’s competence
|
Daniels 2017
[46]
|
Cohort
|
VerdictSearch
|
USA
|
234
|
57.7
|
48.1
|
Spine surgery
|
Adverse events
|
Delays in diagnosing and treating a surgical complication predict legal case outcomes favoring the plaintiff. Catastrophic complications are linked to large sums awarded to the plaintiff and are predictive of
rulings against the physician
|
Eltorai 2018
[47]
|
Cohort
|
VerdictSearch
|
USA
|
43
|
44.2
|
60.1
|
Chest
|
Periprocedural pulmonary aspiration
|
Medical malpractice can be alleged because of failure to uphold currently accepted standards of care even when the published evidence for those standards is weak
|
Engelhard 2016
[48]
|
Cohort
|
Westlaw
|
USA
|
68
|
_
|
younger than 18 years
|
Pediatric Ophthalmology
|
Malpractice litigation
|
Malpractice litigation involving pediatric patients was more
likely to be resolved in favor of the plaintiff and was associated with higher monetary awards than adult litigation
|
Engelhard 2017
[49]
|
Cohort
|
Westlaw
|
USA
|
60
|
_
|
68.8
|
Ophthalmology
|
Ocular oncology
|
Ocular oncology malpractice litigation was relatively rare, and outcomes generally favored defendants
|
Fahimi 2007
[50]
|
Cohort
|
Teaching hospitals in Tehran
|
Iran
|
524
|
_
|
_
|
Intensive care unit
|
Medications
|
a relatively high rate of error in the preparation and administration of commonly used intravenous medications in intensive care unit
|
Fano 2022
[51]
|
Cohort
|
Westlaw
|
USA
|
82
|
49
|
56.9
|
Orthopaedic surgery
|
Hip-related surgeries
|
Within the ten years, there was a significant downtrend in hip surgery malpractice cases filed per year
|
Farooq 2020
[17]
|
Cohort
|
Westlaw
|
USA
|
231
|
62.9
|
44
|
General surgery
|
Gallbladder surgery
|
Minimizing procedural error and improving care of patients after cholecystectomy complications should be emphasized
|
Kumar 2018
[52]
|
Cohort
|
Westlaw
|
USA
|
92
|
71
|
44
|
General surgery
|
Carpal tunnel release
|
Although CTR is generally safe and effective, some patients will experience complications. Median nerve injury was the most common reason for successful litigation
|
Glaser 2017
[53]
|
Cohort
|
Physician Insurers’ Association of America (PIAA) data
|
USA
|
10,915
|
_
|
_
|
Obstetrics and Gynecology
|
Litigation
|
Litigation claims for obstetrics and gynecology procedures have a higher average indemnity of 35 payments and higher paid-to-closed ratios than most other medical specialties
|
Glerum 2018
[54]
|
Cohort
|
Physician Insurers Association of America, Risk Management Report
|
USA
|
8281
|
_
|
9
|
Emergency medicine
|
Pediatric
|
Cardiac conditions, appendicitis, and disorder of the male
genital organs are the most common medical conditions, and errors in diagnosis are the most common chief medical factor in pediatric emergency care malpractice suits
|
Costa 2015
[21]
|
Cohort
|
tertiary cardiology university records
|
Brazil
|
500
|
50
|
59
|
cardiology
|
Obstructive sleep apnoea
|
Despite significant scientific evidence pointing to OSA as an emerging cardiovascular risk factor, OSA is still underdiagnosed in several cardiology subspecialties
|
Kwak 2018
[55]
|
Cohort
|
Supreme Court
|
Korea
|
48
|
_
|
_
|
Ophthalmology
|
Cataract Surgery
|
Doctors were deemed liable in nearly half of the total cases (42%) of medical litigations related to cataract surgery
|
Eltorai 2018
[56]
|
Cohort
|
VerdictSearch
|
USA
|
40
|
39.3
|
56.9
|
Cardiothoracic surgery
|
coronary artery bypass graft
|
Most cardiac surgical malpractice cases involve CABG or valvular surgery, most commonly in the setting of poor prosthetic valve fit or surgical site infection
|
Kain 2006
[18]
|
Cohort
|
National Practitioner Data
|
USA
|
8297
|
_
|
_
|
Anesthesia
|
Payment
|
Over the past 14 years, whereas the number of anesthesia malpractice payments has decreased, the median payment of cases has increased
|
Kent 2017
[19]
|
Cohort
|
Anesthesia Closed Claims Project
|
USA
|
2067
|
49
|
53
|
Anesthesia
|
Orthopaedic Surgery
|
Nonspine orthopedic anesthesia malpractice claims more frequently cited nerve injury and events arising from the use of regional anesthesia than other surgical anesthesia malpractice claims
|
Khaja 2007
[57]
|
Cohort
|
Primary care from the three health centres
|
Bahrain
|
2692
|
_
|
_
|
Family medicine
|
Prescription writing skills
|
Prescription writing skills of the final year residents in an FPRP programme was suboptimal for both PBL and non-PBL graduates
|
Myers 2021
[58]
|
Cohort
|
Harvard’s malpractice insurer
|
USA
|
54,772
|
49
|
44
|
emergency medicine
|
emergency medicine
|
Malpractice claims in EM are often diagnosis- or procedure-related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work
|
Myers 2019 [59]
|
Cohort
|
The Comparative Benchmarking System
|
USA
|
12,078
|
64
|
65
|
Chest
|
Critical Care
|
Malpractice claims involving PCC physicians were distinct from claims
involving internal medicine physicians. Although only one-quarter of claims were paid, the indemnity per claim was high among specialties
|
Boyke 2020
[60]
|
Cohort
|
Westlaw
|
USA
|
47
|
60
|
55.1
|
Neurosurgery
|
meningiomas
|
Over one-half of the cases resulted in a defendant’s verdict, with failure to diagnose cited as the most common reason for litigation. Radiology and neurosurgery were the most common specialties for legal cases, and also
had some of the largest average payouts based on specialty
|
Oetgen 2016
[61]
|
Cohort
|
Physician Insurers Association of America
|
USA
|
25,702
|
_
|
_
|
Orthopaedic
|
Pediatric and Adult Patients
|
Moderate differences in out- comes of orthopedic malpractice claims between adults and pediatric patients
|
Oh 2018
[62]
|
Cohort
|
LexisNexis and Westlaw
|
USA
|
369
|
_
|
_
|
Vascular surgery
|
endovascular therapies
|
Key issues were identified regarding malpractice litigation involving the specialties that commonly perform endovascular procedures. Despite the increasing number of ICs doing peripheral interventions, a large majority of IC cases were related to coronary treatments
|
Otaki 2017
[63]
|
Cohort
|
The Tokyo office of Sompo Japan Nipponkoa Insurance
|
Japan
|
8,530
|
66.7
|
43
|
Rheumatology
|
Septic arthritis
|
It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan
|
Paik 2014
[64]
|
Cohort
|
Westlaw
|
USA
|
292
|
98.6
|
63
|
General surgery
|
Cosmetic Breast Surgery
|
Based on this study, negligent or intentional misrepresentation strongly favors plaintiffs in either awarded damages or settlements in cases of cosmetic breast surgery litigation
|
Palaniappan 2020
[65]
|
Cohort
|
Westlaw
|
USA
|
135
|
33
|
49
|
Cardiology
|
Aortic dissection
|
Plaintiffs frequently cited a failure to diagnose timely, order diagnostic tests, and interpret diagnostic tests as reasons for litigations
|
Palaniappan 2021
[66]
|
Cohort
|
Westlaw
|
USA
|
41
|
46.3
|
38.88
|
Cardiothoracic surgery
|
Heart transplantation
|
There should be an emphasis on documenting informed consent from all involved parties in heart transplantation to limit litigations filed against clinicians
|
Perrotti 2006
[67]
|
Cohort
|
Medical Liability Mutual Insurance Company of New York State
|
USA
|
469
|
_
|
_
|
Urology
|
Payment
|
In the current study, surgical procedures were the greatest generator of claims, with the most common being oncological. Emerging and new technologies, such as laparoscopy and robotics, did not account for the increase in indemnity payments observed to date
|
Read 2005
[68]
|
Cohort
|
One jury verdict and settlement reporter
|
USA
|
2,750
|
_
|
_
|
Dermatology
|
risk management
|
Melanoma is still associated with high risk, and joint conditions are associated with relative claim frequency
|
Reilly 2013
[69]
|
Cohort
|
Westlaw
|
USA
|
94
|
_
|
29
|
Otolaryngology
|
Hearing Loss
|
Otolaryngologists are successful in most (70%) hearing loss litigation brought against them. This is true regardless of whether the allegations are of medical error or include operative procedures
|
Nagieb 2023
[70]
|
Cohort
|
Reports of the Forensic Medical Authority
|
Egypt
|
112
|
53.6
|
_
|
Not specific
|
death
|
The majority of the studied cases were female. Obstetricians had the most accusations in the study and the most positive cases. The most frequent medical error in the study is negligence
|
Palaniappan 2021
[71]
|
Cohort
|
Westlaw
|
USA
|
307
|
27.4
|
61.08
|
Cardiothoracic surgery
|
Coronary Artery Bypass Grafting
|
Defendant verdicts were significantly associated with an alleged reason of procedural errors, an alleged reason of a failure to monitor, and congestive heart failure present in patients
|
Schaffer 2017
[20]
|
Cohort
|
National Practitioner Data Bank
|
USA
|
280 368
|
_
|
_
|
Not specific
|
Payment
|
The rate of malpractice claims paid on behalf of physicians in the United States declined substantially
|
Shah 2018
[72]
|
Cohort
|
Verdict-Search and Westlaw
|
USA
|
240
|
45.2
|
42.1
|
Orthopaedic
|
Arthroscopic Surgery
|
Plaintiff verdict or settlement was seen for vascular complications and wrong-sided surgery, while defense verdicts followed lawsuits alleging surgeon technical error and block-related complications
|
Sullins
2016
[73]
|
Cohort
|
LexisNexis
|
USA
|
236
|
_
|
_
|
Pediatrics
|
Appendicitis
|
A delay in diagnosis was the most common reason for malpractice claims against physician
|
Somville 2016
[74]
|
Cohort
|
university and non-university hospitals
|
Belgium
|
427
|
49
|
47
|
General surgery
|
_
|
System factors play an important role in most surgical errors, including technical and nontechnical errors. Malpractice claims analysis could encrypt the leading areas for intervening to reduce errors
|
Singer 2012
[75]
|
Cohort
|
Physician Insurers Association of America
|
USA
|
380
|
70.5
|
42
|
General surgery
|
Thyroidectomy
|
Malpractice claims related to thyroid surgery are surprisingly infrequent. While the rates of thyroid surgery have risen steadily, there has not been a corresponding increase in the rate of related malpractice claims
|
Almannie 2021
[76]
|
Cohort
|
Annual statistics book of the Medico‑Legal Committees
|
Saudi Arabia
|
3,684
|
_
|
_
|
_
|
_
|
The number of lawsuits in Saudi Arabia is increasing rapidly. Understanding the reason for this is important especially given the high rates of lawsuits for certain specialties and healthcare sectors
|
Yao 2019
[77]
|
Cohort
|
Westlaw
|
USA
|
91
|
_
|
53
|
General surgery
|
Non–Non-Mesh-Related Pelvic Organ Prolapse Surgery
|
The leading allegation of malpractice litigations for non-mesh POP surgery is the negligence of surgery, whereas the most common complication was urinary tract injury
|
Ta 2015
[78]
|
Cohort
|
Westlaw
|
USA
|
123
|
77
|
52
|
Otolaryngology
|
Iatrogenic Dysphonia and Recurrent Laryngeal Nerve Injury
|
Dysphonia is a common complication in several procedures across multiple specialties. Although the majority of cases are decided in favor or the defendant, payments awarded can be considerable
|
Thomas 2017
[79]
|
Cohort
|
Westlaw
|
USA
|
343
|
45
|
47.8
|
Neurosurgery
|
_
|
A defendant’s verdict was reached in nearly one-half of the cases. In instances where a plain- tiff’s verdict was reached, large payouts were common, especially in pediatric and cerebrovascular cases
|
Tolisano 2014
[80]
|
Cohort
|
LexisNexis MEGA Jury Verdicts and Settlements
|
USA
|
51
|
27.4
|
32
|
General surgery
|
Sleep Surgery
|
The majority of outcomes favored the defendant. The type of injury did not predict the outcome. Failure to recognize complications and delay in diagnosis strongly predicted a verdict in favor of the plaintiff
|
Lehmann 2022
[81]
|
Cohort
|
Expert Commission North Rhine
|
Germany
|
8,181
|
_
|
_
|
Dermatology
|
_
|
Compared to the number of dermatological treatments in Germany, patient allegations are rarely raised, indicating greater patient satisfaction and/or a lower risk potential in dermatology.
|