The study involved 267 cases of alleged medical malpractice between 1989 and 2002 that were examined by the Institute of Forensic Medicine at the University of Bonn, Germany. The cases were analyzed to determine whether the allegations of medical malpractice could be appropriately assessed by means of forensic autopsy, whether other experts were consulted, and whether there was a change in the range of subject involved compared to previous studies. In addition, the study considered the clinical disciplines and physicians involved in the case, the nature of the malpractice charges, and the persons informing the prosecution. The findings corroborated those of previous studies by other German Institutes of Forensic Medicine, notably the high number of preliminary proceedings with the charge of involuntary manslaughter and the relatively low number with the charge of bodily injury caused by negligence. There was no significant change in the range of subjects involved compared to former studies. In 69 of 267 cases (25.8 percent), the alleged malpractice was discounted directly by autopsy, or suspected professional negligence was determined not to be the cause of death. When determining whether the cause of death was directly related to the type of medical intervention performed, the case was referred to an expert in the relevant medical discipline. The authors conclude that forensic pathologists are uniquely qualified to collect and present evidence of cause of death and related issues significant for investigators, prosecution, and the court in malpractice cases. 7 tables, 1 figure, and 22 references