Analysis of causative factors and preventive strategies for traumatic orthopedic medical malpractice in Shanghai: a high-responsibility perspective
4 affiliations
- 1Faculty of Military Health Services, Naval Medical University (Second Military Medical University), Shanghai, China
- 2Changzheng Hospital Central Sterile Supply Department, Naval Medical University (Second Military Medical University), Shanghai, China
- 3Department of Health Care, Second Affiliated Hospital of Naval Medical University, Shanghai, China
- 4The Medical Administration and Management Department of the Shanghai Municipal Health Commission, Shanghai, China
Abstract
BackgroundMedical malpractice is recognized as the most severe category of adverse medical events, characterized by illegality, negligent conduct, and resultant harm. Cases classified as high-responsibility-level malpractice impose substantial impacts on healthcare institutions and medical personnel. This study aims to identify negligence-related determinants contributing to such cases and to explore targeted preventive strategies designed to reduce the occurrence of high-responsibility-level medical malpractice.MethodsA total of 125 cases of traumatic orthopedic medical malpractice were retrieved from the Office of Medical Malpractice Handling under the Shanghai Municipal Health Commission. Statistical analyses were conducted using SPSS 26.0. Descriptive data were presented as counts, frequencies, and percentages. Intergroup differences in negligence-related factors between high- and low-responsibility-level categories were evaluated using chi-square tests. Additionally, binary stepwise logistic regression analysis was performed to determine independent associations between specific negligence factors and high responsibility levels.ResultsTraumatic orthopedic medical malpractice cases in Shanghai demonstrated several distinct characteristics, including a relatively low mortality rate (4.00%), a notably high disability rate (74.4%), a greater occurrence in secondary hospitals (60.00%), and increased involvement of attending physicians and associate chief physicians (76.80%). High-responsibility-level cases constituted 45.60% of all included cases. Chi-square analysis indicated that inappropriate surgical procedures and violations of clinical practice standards were significantly more prevalent in the high-responsibility-level group compared with the low-responsibility-level group (P < 0.05). Logistic regression analysis further revealed that inappropriate surgical procedures [odds ratio (OR) = 6.078], violations of clinical practice standards (OR=5.001), and missed or misdiagnoses (OR=2.872) were independently associated with elevated responsibility levels. Stratified regression analysis further indicated that violations of clinical practice standards represented the dominant negligence factor in secondary hospitals (OR=2.94), whereas inappropriate surgical procedures constituted the primary determinant in tertiary hospitals (OR=7.20).ConclusionsSeveral preventive measures are recommended, including strengthening perioperative management, ensuring strict compliance with clinical diagnostic, therapeutic, and nursing protocols, standardizing imaging examinations and comprehensive physical assessments to reduce missed and misdiagnoses, enhancing physician–patient communication, standardizing medical record documentation, and reinforcing early postoperative rehabilitation strategies.
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BibTeX
@article{chen2026analysis,
title = {{Analysis of causative factors and preventive strategies for traumatic orthopedic medical malpractice in Shanghai: a high-responsibility perspective}},
author = {Chong Chen and Hong Gao and Shiying Wang and Lei Yuan and Weixiang Xu and Hongli Yan and Xiaofei Ye and Haixia Qi and Yang Li and Yuqin Ma and Hong Wu and Ping Xu},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1930290},
url = {https://doi.org/10.3389/fsurg.2026.1930290},
note = {CC BY},
}
RIS
TY - JOUR
TI - Analysis of causative factors and preventive strategies for traumatic orthopedic medical malpractice in Shanghai: a high-responsibility perspective
AU - Chong Chen
AU - Hong Gao
AU - Shiying Wang
AU - Lei Yuan
AU - Weixiang Xu
AU - Hongli Yan
AU - Xiaofei Ye
AU - Haixia Qi
AU - Yang Li
AU - Yuqin Ma
AU - Hong Wu
AU - Ping Xu
PY - 2026
DA - 2026/10/30
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1930290
UR - https://doi.org/10.3389/fsurg.2026.1930290
AB - BackgroundMedical malpractice is recognized as the most severe category of adverse medical events, characterized by illegality, negligent conduct, and resultant harm. Cases classified as high-responsibility-level malpractice impose substantial impacts on healthcare institutions and medical personnel. This study aims to identify negligence-related determinants contributing to such cases and to explore targeted preventive strategies designed to reduce the occurrence of high-responsibility-level medical malpractice.MethodsA total of 125 cases of traumatic orthopedic medical malpractice were retrieved from the Office of Medical Malpractice Handling under the Shanghai Municipal Health Commission. Statistical analyses were conducted using SPSS 26.0. Descriptive data were presented as counts, frequencies, and percentages. Intergroup differences in negligence-related factors between high- and low-responsibility-level categories were evaluated using chi-square tests. Additionally, binary stepwise logistic regression analysis was performed to determine independent associations between specific negligence factors and high responsibility levels.ResultsTraumatic orthopedic medical malpractice cases in Shanghai demonstrated several distinct characteristics, including a relatively low mortality rate (4.00%), a notably high disability rate (74.4%), a greater occurrence in secondary hospitals (60.00%), and increased involvement of attending physicians and associate chief physicians (76.80%). High-responsibility-level cases constituted 45.60% of all included cases. Chi-square analysis indicated that inappropriate surgical procedures and violations of clinical practice standards were significantly more prevalent in the high-responsibility-level group compared with the low-responsibility-level group (P < 0.05). Logistic regression analysis further revealed that inappropriate surgical procedures [odds ratio (OR) = 6.078], violations of clinical practice standards (OR=5.001), and missed or misdiagnoses (OR=2.872) were independently associated with elevated responsibility levels. Stratified regression analysis further indicated that violations of clinical practice standards represented the dominant negligence factor in secondary hospitals (OR=2.94), whereas inappropriate surgical procedures constituted the primary determinant in tertiary hospitals (OR=7.20).ConclusionsSeveral preventive measures are recommended, including strengthening perioperative management, ensuring strict compliance with clinical diagnostic, therapeutic, and nursing protocols, standardizing imaging examinations and comprehensive physical assessments to reduce missed and misdiagnoses, enhancing physician–patient communication, standardizing medical record documentation, and reinforcing early postoperative rehabilitation strategies.
SN - 2296-875X
ER -