Clinical negligence in foot and ankle surgery

Abstract

We present a review of litigation claims relating to foot and ankle surgery in the NHS in England during the 17-year period between 1995 and 2012. A freedom of information request was made to obtain data from the NHS litigation authority (NHSLA) relating to orthopaedic claims, and the foot and ankle claims were reviewed. During this period of time, a total of 10 273 orthopaedic claims were made, of which 1294 (12.6%) were related to the foot and ankle. 1036 were closed, which comprised of 1104 specific complaints. Analysis was performed using the complaints as the denominator. The cost of settling these claims was more than £36 million. There were 372 complaints (33.7%) involving the ankle, of which 273 (73.4%) were related to trauma. Conditions affecting the first ray accounted for 236 (21.4%), of which 232 (98.3%) concerned elective practice. Overall, claims due to diagnostic errors accounted for 210 (19.0%) complaints, 208 (18.8%) from alleged incompetent surgery and 149 (13.5%) from alleged mismanagement. Our findings show that the incorrect, delayed or missed diagnosis of conditions affecting the foot and ankle is a key area for improvement, especially in trauma practice.

Factors Associated With Physician Loss in Anterior Cruciate Ligament Reconstruction Malpractice Lawsuits

“… 10 Interestingly, in this study, death did not increase the chance of successful litigation, again supporting the notion that routinely discussed postoperative complications are less likely to result in indemnity payments, even with the ultimate outcome of death. 23 …”

Malpractice lawsuits in orthopedic trauma surgery: a meta-analysis of the literature

“…The 13 articles reviewed were published between 2003 and 2019. Collectively, the 13 studies [1,[5][6][7][8][9][10][11][12][13][14][15][16] analyzed data on 23,716 claims related to orthopedic surgery from a private collection, single-center institutions, and various databases, including the Physician Insurers Association of America, VerdictSearch, and National Health Service Litigation Authority in the United Kingdom. The date ranges of claims reviewed went as far back as 1985 from the Physician Insurers Association of America to cases in 2016 from the Westlaw database.…”

“…Among these studies, it was found that lawsuits related to lower extremity injury were more common than those of upper extremity injury, which was more common than axial skeleton. The other 4 studies were specific to a body part (scaphoid, ankle, shoulder, and elbow) [5,12,13,15] . The upper limb was most commonly involved in the 2 pediatric studies included in the review [7,9] …”

“…The other 4 studies were specific to a body part (scaphoid, ankle, shoulder, and elbow). [5,12,13,15] The upper limb was most commonly involved in the 2 pediatric studies included in the review. [7,9] Supplemental Table 2 (http://links.lww.com/OTAI/A42) summarizes the results for the meta-analysis of frequencies of the lower limb and upper limb injuries.…”

“…Looking at the cases overall, lower limb injury had a relatively high frequency and often resulted in some of the highest payouts in favor of the plaintiff. [12,25] Of lower limb cases, surgeries of the hip and knee proved to be some of the most frequently performed.…”