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Objective: Malpractice lawsuits are increasing in our country as well as around the world recently. Malpractice lawsuits in our country in the field of psychiatry are less than other medical branches. In a study (Pakis et al. 2008) evaluating 525 malpractice cases, which resulted in death; there were only two psychiatry cases (0.4%). Insufficient patient safety, early discharge of patients, misdiagnosis, lack of consultation, the side effects and also drug abuse due to high-dose drug usage are the common causes of malpractice complaints in abroad. There are few studies in the field of psychiatric malpractice in Turkey. Therefore in this study our aim is to evaluate the results of medico-legal malpractice cases in the field of psychiatry.
Methods: This study was conducted in Istanbul, the archive records of evaluated malpractice cases by the 3rd Speciality Board of Council of Turkish Forensic Medicine between the years 2005-2010 were reviewed and 27 cases related Psychiatry were included.
Results: Eight of the grievances occurred in dispensaries and military hospitals, 7 in psychiatric hospitals, 6 in emergency services and the others were in different places. 23 of the defendants were psychiatrists and 4 of them were medical doctors from other clinics. 9 of the defendants were complained together with medical doctors from other clinics or health care workers. 16 of the defendants were male, 11 of them were female. 3th Speciality Board of Institute of Forensic Medicine’s decisions about the cases were as below; in 14 of the cases there were no malpractice, in 9 of the cases there was malpractice, 3 of them couldn’t be evaluated and in one of the cases must be evaluated by the court because of missing file. 16 of the victims were male and 11 of them were female. The average age of the cases was 35.1, (between 19 and 66 years old) 22 of the victims were dead, 5 of them were alive and well and one of them was disabled because of sequel of encephalitis. The autopsy was performed for 16 of dead victims and not performed for the rest of them. The boards decisions about the cause of death were as below: 7 of them couldn’t be determined, 3 of them were because of pneumonia, 2 of them were due to hanging, and the others were different causes like sepsis, brain damage due to gun shot injury, gastric perforation and hemorrhage due to taking a corrosive substance, myocardial infarction, cardiac arrest due to taking haloperidol, cardiovascular disease resulting pulmonary edema, cerebral hemorrhage, blunt head-abdominal and thoracic trauma, penetrating thoracic injury, general body trauma due to jump from a height.
Conclusion: Most of the victims were young adults. Most of the complaints about Psychiatric malpractice were cases with death. Therefore psychiatrists have to do a detailed evaluation, be careful and intentive about requested consultations from emergency services or other clinics, exclude the organic etiology and also be aware of the risk of suicide.