University of Oulu

Kuvaja, P., Keinänen, N., & Pakanen, L. (2022). The incidence of iatrogenic deaths in the Finnish cause-of-death statistics; a retrospective study. Journal of Forensic and Legal Medicine, 86, 102302.

The incidence of iatrogenic deaths in the Finnish cause-of-death statistics : a retrospective study

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Author: Kuvaja, Paula1; Keinänen, Noora1; Pakanen, Lasse1,2
Organizations: 1Forensic Medicine Unit, Finnish Institute for Health and Welfare (THL), P.O. Box 310, FI-90101, Oulu, Finland
2Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Elsevier, 2022
Publish Date: 2022-06-22


Purpose: An adverse event in health care leading to death is a significant event when assessing patient safety. This study was designed in order to assess, how many iatrogenic deaths are registered in Finland annually, and what type of treatment they are mostly related to.

Methods: Material was collected using cause of death-statistics that includes “manner of death”-classification in Finland in 2014–2015.

Results: There were 350 cases that met the criteria of the study. In a majority of the cases (264, 75%), a medico-legal autopsy was performed. This represents only 1.4% of all medicolegal autopsies during the study period in Finland. The cases were most often related to medication (30%) or known high-risk procedures such as gastrointestinal surgery (23%) and cardiothoracic surgery (11%). Only 12% of the cases had no prior significant medical history. Patient characteristics were somewhat different among the surgical disciplines, probably reflecting treatment practices.

Conclusions: Deaths that are classified as iatrogenic are mostly related to known high-risk surgery or medication. Further studies are needed to assess the true incidence of malpractice among this material.

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Series: Journal of forensic and legal medicine
ISSN: 1752-928X
ISSN-E: 1878-7487
ISSN-L: 1752-928X
Volume: 86
Article number: 102302
DOI: 10.1016/j.jflm.2021.102302
Type of Publication: A1 Journal article – refereed
Field of Science: 319 Forensic science and other medical sciences
Copyright information: © 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (