Abstract
The analysis of court decisions on medical malpractice can provide a detailed picture of patient mortality and morbidity and the causes that led to medical malpractice. The purpose of our research is to analyze, through published court decisions, cases of alleged medical errors by cardiologists in Greece. This is a retrospective study. Court decisions on medical malpractice by specialists and residents in cardiology from 1990 to 2024 were searched in Greek legal banks. The causes of manslaughter and bodily harm by negligence and the criteria for attributing liability were recorded. Forty-six court cases involving cardiologists were found, including 27 (58.7%) convictions and 19 (41.3%) acquittals - rejections of compensation. Among convictions, 25 (92.59%) involved manslaughter. These decisions concerned 27 patients (11 women and 16 men), with a mean age of 51.82 ± 22.72 years (range 25-84 years). The average compensation amounts imposed were 128.224 ± 71,980 €. In criminal cases, prison sentences ranged from six to 30 months with a three-year suspension. The duration of the legal dispute ranged from three to 20 years (average 5.93 ± 3.35 years). The main causes of manslaughter and bodily harm due to negligence were myocardial infarction (n = 9, 33.33%) and ruptured thoracic and abdominal aortic aneurysm (n = 5, 18.5%). Complications were mainly due to incorrect or delayed diagnosis (n = 17, 62.96%), delayed treatment (n = 14, 51.85%), incorrect treatment (n = 9, 33.33%), and incomplete ordering of diagnostic tests (n = 7, 25.9%). The findings reveal that while cardiology is generally considered a low-risk specialty, when malpractice cases do occur, they are associated with severe outcomes - most notably, a high rate of manslaughter convictions. The most common clinical scenarios leading to legal liability involved acute coronary syndrome and aortic aneurysm rupture, with diagnostic errors, delayed or incorrect treatment, and failure to order necessary tests being the most frequent causes of adverse outcomes. The prolonged duration of litigation and the emotional and financial burden it imposes on both physicians and patients also underline the need for reforms that promote faster resolution and reinforce quality and safety in healthcare delivery.