Organizational liability: new frontier of medical malpractice?. Seventeen-year experience as a medico-legal observer

BACKGROUND: The study of claims for medical malpractice can be a useful tool to understand Clinical Risk. Indeed, the identification of the events that cause or foresee damage to the patient allows the proposal of new strategies to prevent the recurrence of the same event. This ensures better medical case security and health maintenance of individuals and overall society. In particular, this study focuses on the cases regarding secondary errors due to organizational deficit in order to understand the origins of such organizational deficit and to start specific prevention measures. METHODS: The claims for medical damage were analyzed in the period between 1st January 2003 and 31st December 2019 and divided in specific sub-categories. RESULTS: The claims due to deficiencies in organizational responsibility covers 10% of the total cases. The distribution according to the macro-areas shows that the surgical field is the most represented area (68%). The classification of these deficiencies shows the preponderance of "sentinel events" (30%) compared to "diagnostic/therapeutic delay" (27%) and "infections" (23%). CONCLUSIONS: From the present research, it was possible to identify the main cause of errors and propose specific risk mitigating measures to prevent such errors due to system deficiencies.