Analysis of medical liability in Emergency Care in Catalonia (Spain) from 2000 through 2019

Introduction. Hospital emergency departments (EDs) are the cornerstone of health care delivery and characterized by high complexity and frequent overcrowding, which increase the risk of claims related to alleged malpractice. The objective was to analyze claims arising from hospital emergency care in Catalonia (Spain) (2000–2019) and identify factors associated with medical professional liability (MPL).

Methods.

Retrospective observational study based on documentary/insurance records of claims registered by the Consell de Col·legis de Metges de Catalunya (Catalonia, Spain). Hospital emergency care episodes were included, and demographic, clinical, and legal variables were analyzed. MPL was defined as a compensation agreement or an adverse court ruling. Descriptive and inferential statistics (P < .05) were applied, along with a multivariable logistic regression model.

Results.

Of 6,289 claims, 654 (10.4%) corresponded to emergency care, 554 of which (84.7%) involved hospital emergency care. The claim rate dropped significantly during the study period (P < .05). In the multivariable analysis, private health care (OR, 2.10; P < .05) was independently associated with MPL. Criminal proceedings predominated (60%), particularly in public centers. MPL was confirmed in 18.0% of cases and was more frequent in civil proceedings (37.6%). The median compensation was €43,937. The main reason for claims was diagnostic error or delay (56.5%), particularly in trauma-related conditions, chest pain, and abdominal pain.

Conclusions.

EDs are a major focus of litigation. Improvements in clinical training, diagnostic protocols, and medicolegal competencies could reduce litigation.