The risk of malpractice litigation in care to head-injury patients in comparison with other high-risk patient groups: an inpatient-based epidemiological study in Taiwan

Background: The purpose of this study was to assess the risk of being sued in district courts for care for head-injury patients from the perspective of epidemiology. Methods: This research was designed to be a retrospective population-based cohort study. We researched the incidences of litigations arising from head-injury inpatients under neurosurgical care, all neurosurgical inpatients, and birth inpatients in Taiwan, and computed their relative risks. The study period was from 1998 to 2002. Results: The average annual incidence rate of becoming a plaintiff for head-injury neurosurgical inpatients was 15 per million; for all neurosurgical inpatients 11.8 per million; and for birth patients 33.5 per million. The relative risk comparing head-injured neurosurgical inpatients against all neurosurgical inpatients was 1.27; whereas comparing head-injury neurosurgical inpatients against birth inpatients was 0.45, and comparing all neurosurgical inpatients against birth inpatients, 0.35. Conclusions: The findings of our population-based study indicate that for the inpatient populations, whether head-injury patients or not, neurosurgeons in Taiwan are facing a relatively lower rate of litigation in comparison with those treating birth patients. Nonetheless, head-injury patients still pose a major challenge in the ED, and misdiagnosis remains the major complaint of plaintiffs in subsequent litigations.