*Strengths and Limitations*

This study has several strengths and limitations. Regarding the strengths, this study is the first of its kind to be conducted in Romania and covered a significant geographic part of the country, Moldova being one of the largest Romanian regions. Therefore, the results offer an image of the situation for about 20% of the country's entire population and can represent the starting point for studies in the other regions, to have a national perspective on this subject. Second, the research analyzed complaints registered for 14 years, offering an objective data analysis. Third, the results are discussed and explained in opposition with other medical systems showing the most vulnerable medical specialties in Romania compared to other countries.

The limitation of the study stems from the fact that some of the cases had missing data regarding the socio-demographic characteristics of the plaintiffs and some of the claims did not contain precise information on the number of doctors involved. This limitation was the result of the fact that the patients gave a personal account of the events, instead of having access to a default form with specific items for each category of information.

## **5. Conclusions**

Complaints of medical malpractice continue to follow an ascending trend worldwide, and their consequences are multifaceted, affecting both the medical staff and patients and society in general. Therefore, it becomes significantly necessary to identify solutions meant to reduce the number of complaints, a goal that could be met by conducting studies aimed at formulating recommendations in this regard.

The results of our study showed that the most frequently involved specialties were obstetrics and gynecology, emergency medicine, general surgery, and orthopedics and traumatology. Particularly in this list was the presence of the emergency medicine, a result explained by the overuse of these services in our country and the underutilization of primary health care services. Therefore, health policies are needed to divert the large number of patients accessing emergency medicine to primary care.

Many of the aspects the plaintiffs complained about were represented by deficiencies in the interaction between doctor and patient or his/her family (lack of or deficiency in information, the doctor's inappropriate behavior or language, failure to obtain informed consent). Based on this finding, we consider that doctors need special training during their undergraduate medical studies, as well as periodic updating during their career to meet the challenges of communication and relationships with patients and their families.

**Author Contributions:** All authors had equal contributions. Conceptualization, B.H. and B.G.I.; methodology, B.H., B.G.I., and M.I.; software, I.-D.M. and B.H.; validation, B.H., B.G.I., and M.I.; formal analysis, I.-D.M. and

B.H.; investigation, B.H. and B.G.I.; resources, B.H., B.G.I., M.I., and I.-D.M.; data curation, B.H. and B.G.I.; writing—original draft preparation, B.H.; writing—review and editing, B.H., B.G.I., M.I., and I.-D.M.; supervision, B.G.I. and M.I.; project administration, B.G.I. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest.
