La responsabilité médicale en obstétrique au Maroc: analyse des dossiers des contentieux judiciaires entre 2015-2018

Reflections on professional responsibility in Morocco are in clear development. Health professionals and especially obstetricians are reporting a dire situation due to limited resources and the lack of a clear legal framework that protects them, given that litigations are on the rise in recent years. We collected medical records of obstetric litigations adjudicated at the litigation department of the Ministry of Health in Morocco over a period of three years (2015-2018), with the aim of assessing the current situation of professional responsibility in obstetrics and indentifying failures in obstetric litigation management as well as developing recommendations tailored to the Moroccan context. Among the 111 medical litigations adjudicated over the study period, 56% (n=62) concerned obstetric activity and 84% (n=54) complications during labor; brachial plexus was the most registered complaint (61.3%; n=39). The analysis of data on medical expertise from these medical records revealed a non-compliance with quality in 88.7% of cases (n=55), the condemnation of professional birth attendants in 93.5% (n=58), a lack of documentation in the medical records in 35 % of cases (n=22). Litigations are more recorded in obstetrics than in other areas of the public health sector in Morocco. The lack of documentation and the complexity of management of the litigation process as well as the tendency to compensate patients in the absence of a structure of medical care for victims of therapeutic hazards are the most frequent causes of claimants´ gain.