Professional Liability in Psychiatry

Introduction. Patient safety and malpractice litigation risks are major concerns in Medicine, in Psychiatry as well. Material and Methods. Descriptive analysis of clinical and legal characteristics of claims related to psychiatry, opened between 1986 and 2009 at the Council of Physicians Colleges in Catalonia. Results. We identified 94 cases in 23 years, major allegations were related to diagnosis (63.83%, including suicide risk assessment) and the legal concept of homicide by professional imprudence (46.8%). Claims most frequently related to hospital care (62.77%), happened at the hospital floor (30.85%), during urgent care (52.3%) and related to team work (53.75%). The patient was most frequently male (51.58%) with mean age of 36.6 years. Half of the cases involved the patient's death. 139 physicians were sued, predominantly males (69.57%) with a mean age of 41 years and Spanish (91.4%). Mean time elapsed between the physicians' act and the claim was 1.28 years, and it took 2.68 years to solve the procedure. Most claims were solved at court (77.66%) and among those 95.77% were closed without consequences, 2 ended up with a sentence (2.81%) and 1 with an economical transaction (1.41%). Conclusions. The cumulative incidence of 0.013 (1.35%) in 23 years reflects a low risk of malpractice claims in Psychiatry, with a low rate of cases solved in favor of the plaintiff and low payouts. However, there are specific clinical safety issues that should be taken into account, such as suicide risk assessment.