Research Appraisalobservational

Evaluating Alleged Malpractice Cases Against Cardiologists and Cardiothoracic Surgeons in The Netherlands

Interdisciplinary cardiovascular and thoracic surgeryHarlianto, Zaneta N, Harlianto, Netanja I9 June 2026DOI

Clinical Snapshot

80CEBM
Evidence: Moderateobservational

PICO Framework

P — PopulationCardiologists and cardiothoracic surgeons in the Netherlands with alleged malpractice cases (2010-2025)
I — InterventionNot applicable (observational study)
C — ComparatorComparison between cardiology and cardiothoracic surgery malpractice cases
O — OutcomesMalpractice case outcomes, disciplinary actions, case characteristics, and trends

Bottom Line

This comprehensive analysis of 219 malpractice cases against Dutch cardiovascular specialists reveals that approximately one-quarter to one-third of allegations result in disciplinary action, with diagnostic and treatment errors being the most common issues. While cardiothoracic surgeons had slightly higher rates of founded cases (30% vs 25%), both specialties predominantly faced allegations related to clinical decision-making rather than procedural complications. The study provides valuable benchmarking data for cardiovascular specialists and highlights the importance of robust diagnostic processes and treatment protocols. However, the findings should be interpreted cautiously when applying to Australian practice, given differences in healthcare systems and legal frameworks. The data supports the need for ongoing professional development focused on diagnostic accuracy and evidence-based treatment protocols.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: 25% (45/182) for cardiologists vs 30% (11/37) for cardiothoracic surgeons

  • Primary Outcome: Proportion of founded malpractice cases

  • Nnt Or Sensitivity: Most common allegation: incorrect treatment/diagnosis (57% cardiology, 68% cardiothoracic surgery)

  • Confidence Interval: Not reported

Clinical Application

Results inform risk management and quality improvement initiatives Relevant for AHPRA processes and RACGP/CSANZ quality initiatives, though Dutch legal framework differs from Australian Medical Board procedures Cardiovascular specialists in developed healthcare systems with formal disciplinary processes

Abstract

This study aimed to analyse alleged malpractice cases and outcomes against cardiologists and cardiothoracic surgeons in the Netherlands. The Dutch Medical Disciplinary Database was searched for verdicts of alleged malpractice cases published between January 2010 and October 2025. Data were collected on case details and outcomes, and descriptive statistics were employed. A total of 219 cases were included (182 cases for cardiology and 37 cases for cardiothoracic surgery). Most cases were due to incorrect treatment/diagnosis for cardiologists and cardiothoracic surgeons (57% and 68%, respectively). Against cardiologists, 45/182 cases (25%) were judged as (partially) founded, for which 25 warnings, 17 reprimands, 1 temporary suspension, and 1 full practice prohibition were imposed. Against cardiothoracic surgeons, 11/37 cases (30%) were judged as (partially) founded, for which 10 warnings were imposed. We report trends and outcomes of alleged malpractice claims against cardiologists and cardiothoracic surgeons in the Netherlands. The cases discussed in this article offer valuable insights that can help enhance patient care.

References

  1. 1.Harlianto, Z. N., & Harlianto, N. I. (2026). Evaluating Alleged Malpractice Cases Against Cardiologists and Cardiothoracic Surgeons in The Netherlands. Interdisciplinary Cardiovascular and Thoracic Surgery. https://doi.org/10.1093/icvts/ivag148
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