The forensic medical evaluation of medical malpractice claims in the field of medical pathology.

Abstract

Just like in other medical specialties, medical malpractice claims arise in pathology as well. Although the exact rate of malpractice related to pathology cannot be clearly stated in Turkey, it is known to occur more frequently during the diagnosis stage, as reported worldwide. This study discusses the measures that should be taken to prevent these claims by comparing cases with alleged malpractice in pathology, evaluated by the Council of Forensic Medicine, with the literature. Reports in which the pathologist or the procedure is directly or indirectly accused and in which a medical malpractice claim related to a pathologist or procedure was questioned, were retrospectively reviewed from the archive by the 7th Specialization Board of the Council of Forensic Medicine. The patients' clinical complaints, the procedures performed, histopathological diagnoses of tissue samples, the court inquiry, the re-evaluation of the slides in the relevant department, and the outcome of the relevant board were analyzed in conjunction with the literature. It was found that the majority of the cases were related to the breast (37.5%) and the urogenital system (37.5%). In seven cases, the court directly questioned the pathologist's fault, while in nine cases, the fault of all doctors was questioned. In two cases, the failure to perform immunohistochemical examination was considered a medical practice error. In the breast cases, the pathologist's diagnosis was incorrect in two cases, and in a lymphoma case, the pathologist's diagnostic error did not cause harm to the patient but was considered a lack of diligence. Improving the working conditions of pathologists, enhancing communication between clinicians and pathologists, having clinicians correlate pathology diagnoses with clinical findings before initiating treatment, and ensuring that immunohistochemical examinations are not neglected in necessary cases are among our medical recommendations. To ensure that the judicial process progresses within a scientific framework, we also recommend the establishment of Specialization Courts dedicated solely to malpractice, as well as the creation of a pool of expert pathologists who are trained and certified to serve as expert witnesses for the courts. Additionally, with future studies, medical malpractice claims related to pathology can be discussed in greater depth.