Ten-year retrospective study on medico-legal risk of family physicians providing anaesthesia care in Canada, 2013–2022

This research paper aims to describe the expert criticisms from medico-legal cases involving family physicians providing care within the scope of anaesthesia.

Abstract

Introduction: Anaesthesiologist medico-legal risk is well reported in the literature, however, there is little data regarding the medico-legal risk of family practice anaesthetists (FPAs) in Canada. We aimed to describe the expert criticisms from medico-legal cases involving family physicians providing care within the scope of anaesthesia.

Methods: Medico-legal cases involving FPAs providing anaesthesia-related care were identified from a national repository at the Canadian Medical Protective Association. Civil legal cases, medical regulatory authority (college) complaints and hospital complaints were included in the descriptive analysis where medical coding was available. Cases were closed between 1 January 2013 and 31 December 2022.

Results: There were 50 medico-legal cases involving 50 FPAs providing anaesthesia-related care to 50 patients. At least half of the cases involved American Society of Anaesthesiologists Physical Status Classification I and II patients in an outpatient or ambulatory setting. Thirty patients experienced healthcare-related harm, of which most were classified as moderate, severe or death. Expert criticisms were mainly associated with situational awareness, clinical decision-making, documentation and communication issues with the patient, family or substitute decision-maker.

Conclusion: This study presents family physicians providing anaesthesia-related care with an opportunity to increase their awareness of commonly identified expert criticisms from medico-legal cases related to their area of practice. While the medico-legal risk we report is predominantly associated with provider and team factors, the retrospective nature of medico-legal cases makes the assessment of system factors difficult and thus requires further investigation. Nonetheless, FPAs are pivotal to and growing in number in the Canadian healthcare context and, therefore, this study could contribute to developing targeted training and education programmes to promote patient safety within their scope of practice.

Reference

Ambati D, Lemay K, Steen A, Jin S, Smith J, Garber G. Ten-year retrospective study on medico-legal risk of family physicians providing anaesthesia care in Canada, 2013–2022. Canadian Journal of Rural Medicine. 30(1):p 31-38, Jan–Mar 2025. doi: 10.4103/cjrm.cjrm_27_24