Medico-legal litigation in obstetrics and gynecology: an eleven-year case series and comparison of out-of-court resolution and legal proceedings

Litigation presents a significant and pervasive challenge within the practice of Obstetrics and Gynecology (OB/GYN). A central objective of this research is to conduct a comparative analysis of the compensation claims initially filed by patients (or their attorneys) in the pre-litigation phase and the final outcomes of the cases actually brought in court. This investigation represents a crucial opportunity to critically and in-depth analyze the phenomenon of litigation in Obstetrics and Gynecology, with the aim not only of improving the efficiency of managing such cases, but also of increasing awareness and consolidating fundamental knowledge of this complex issue among specialists in the Obstetrics and Gynecology field. This study examines claims for alleged medical negligence in Obstetrics and Gynecology related to one of the largest hospitals in Italy. Gynecological-obstetric disputes represent approximately 3.99% of all claims, of which 51.5% are gynecological claims and 48.5% are obstetric. Of the 68 claims received, 42 were accepted as professional liability was established; 25 were rejected due to failure to identify medical liability; and 1 was unclear due to the lack of a supplementary specialist report. The study shows that a total of € 2,501,270 was settled for a total of 44 compensation cases. The analysis of our case history highlights how medico-legal disputes represent a significant challenge for gynecologists and obstetricians. Especially in the latter area, when medical liability is established, the compensation payments are extremely high and risk undermining the hospital's insurance system.