Systematic review of medical literature for medicolegal claims and complaints involving neonates

Abstract

IMPORTANCE: Complaints and malpractice claims by families on the care of their babies are pertinent issue. Beyond just the financial implications, it involves harm to babies and distress to parents. OBJECTIVE: The aim was to review published reports of complaints by families on the care of their babies in the neonatal units in order to understand the nature of these complaints and the areas of care that they relate to. METHODS: We considered articles in English, which report on complaints made by families to organisations providing neonatal care. We performed our structured search on AMED, CINAHL, EMBASE, EMCARE, SCOPUS and MEDLINE from January 2000 to December 2020. A total of 378 articles were appraised using eligibility criteria. RESULTS: A total of 12 articles were included. The most common category of complaint was delayed/incorrect diagnosis. Communication issues were highlighted as a significant category of complaints. The majority of such claims were between the physicians and families. Factors implicated for clinician's errors that resulted in complaints were lack of clinical and communication training, inadequate supervision of junior clinicians, work culture and hierarchy, not listening to families' concerns and system failure. CONCLUSIONS: The most frequent categories of complaint reported in our systematic review were delayed/incorrect diagnosis and delayed/incorrect treatment. Organisations should be encouraged to share complaints data as it can facilitate shared learning. An understanding of human factor principles and its role in patient safety is also emphasised in this report in order to optimise patient outcomes and improve experience for families requiring neonatal care.