Medical malpractice and diagnostic errors in emergency departments: the case of Turkey

Background: Emergency departments (EDs) operate 24/7, providing continuous healthcare services to individuals of all age groups and socioeconomic backgrounds. Physicians working in EDs often face high-pressure situations, requiring them to make rapid, high-stakes decisions for undifferentiated patients based on limited clinical information, which also increases their vulnerability to medical malpractice claims. This study aims to analyze malpractice cases involving negligent homicide in Turkish EDs by reviewing rulings from the Turkish Court of Cassation to identify the underlying causes and characteristics of such cases. Methods: A comprehensive search was conducted on the Turkish Court of Cassation’s official website using the keywords “Emergency Department”, “Emergency Medicine” and “Emergency Medical Intervention”. The search yielded 11,131 results from a total of 9,154,439 judicial decisions. After reviewing cases between 2012 and 2024, 92 malpractice cases involving negligent homicide were included in the analysis. Results: The high judiciary upheld a guilty verdict against the physician in one out of every five malpractice cases related to negligent homicide. General practitioners were the most frequently implicated physicians, accounting for 41.3% of cases. The most common reason for malpractice claims was a “failure to conduct adequate medical evaluation” (58.1%). The gastrointestinal system was the most frequently involved medical category, with gastrointestinal bleeding or perforation identified in 15.2% of cases. Conclusions: EDs present a high-risk environment for malpractice claims involving negligent homicide. In Turkiye, EDs employ a substantial number of general practitioners alongside emergency medicine specialists, leading to a higher proportion of malpractice cases involving general practitioners. As demonstrated in this study, the failure to conduct an adequate medical evaluation remains the leading cause of malpractice claims. To mitigate these risks, it is essential to strengthen adherence to clinical practice guidelines and standardized protocols in both medical school and residency training.

Emergency department; Medical malpractice; Negligent homicide; Diagnostic errors; Medical evaluation

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