A detailed analysis of pediatric surgical malpractice claims in Germany: what is the probability of a pediatric surgeon to be accused or convicted?

Abstract

Aim of the study Pediatric surgeons treat a vulnerable population in which unfavorable outcome can lead to substantial long-term costs, placing them at risk for malpractice claims. This study aims to characterize the frequency and circumstances in which malpractice claims were successfully brought against pediatric surgeons in Germany over the last 5 years. Materials and methods Anonymous data on medical treatment errors and payments were acquired from the Federal Chamber of Physicians from 2014 through 2018 and analyzed for most frequent diagnoses and circumstances that resulted in accusation or conviction. Those claims that were successfully rebutted were compared to as controls. Lifetime risk for being involved in litigation and its outcome was calculated. Results There were 129 medical malpractice claims over the 5-year observation period. Medical error was confirmed in 56 cases (43%); the rest were successfully appealed. The risk of the prototypical German pediatric surgeon to be accused was 5.24% and to be convicted 2.27% per year in practice. The most common reasons for conviction (alone or in combination) were surgical-technical errors (23%), treatment delay (21%), insufficient workup (17%), incorrect diagnosis (17%), and incomplete consent (16%).The most frequent circumstances leading to a conviction were trauma (27%), inguinal hernia (7%), circumcision (7%), testicular torsion (7%), acute abdomen (7%), and appendicitis (5%). Conclusion Over a 40-year career, pediatric surgeons in Germany face an average calculated risk of 2.1 to be accused and 0.9 to be convicted of malpractice claims. Certain circumstances pose higher risks for litigation than others. Knowledge of these patterns may help practitioners avoid medicolegal confrontation.

Ten Years Analysis of Parental Counselling-in-Continuum in Paediatric Surgery

“…The risk of conviction for these litigations was found to be 2.27% per year for a paediatric surgeon. [ 10 ] Another study from the United States of America reported that 41% of total medico-legal cases were lodged against paediatric surgeons, making them most vulnerable to getting sued. [ 11 ]…”

Even A Worm Will Turn: Appendicitis Malpractice Litigation Since 2020

“…Appendicitis malpractice litigation is also a global problem. In Germany for example, pediatric appendicitis malpractice claims analysed over a 5 year period revealed that the most common reasons for conviction were surgical technical errors, and delayed diagnosis 27 . To decrease the risk of litigation, the authors recommend the objective and professional documentation of all interactions, to accept ones limits and seek help for unfamiliar cases, and to maintain transparent communication with parents and family members 27 .…”

Begutachtung im Kindesalter

“…Auch vor der Volljährigkeit werden die Schlichtungsstellen der Ärztekammern um ihre juristisch fundierten und gutachterlich basierten Empfehlungen gebeten, die Amts-und Landgerichte mit Behandlungsfehlervorwürfen beschäftigt und die medizinischen Dienste der Krankenkassen geben ihre Einschätzung ab. Somit ist die Begutachtung auch im Kindesalter ein Spiegel des Komplikationsspektrums und des Fehlermanagements und betrifft national und international in besonderer Weise die Frakturversorgung [3,6,11,12].…”