Wrist and scaphoid fractures: A 17-year review of NHSLA litigation data

Ring, J.; Talbot, Christopher; Price, James H.; Dunkow, P

doi:10.1016/j.injury.2015.01.017

Cited by 25 publications

(15 citation statements)

References 8 publications

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“…Our results support existing malpractice literature on hand and upper extremity surgery. 7,9,10 Carpal tunnel syndrome is a well-established trigger of litigation, as is nerve injury in the setting of fractures of the upper extremity. 6,7 Only 8% of claims went to trial, which were overwhelmingly in favor of the defendant (83%).…”

Section: Discussionmentioning

confidence: 99%

Medical Malpractice in Nerve Injury of the Upper Extremity

Krauss

Shankar

Patterson

et al. 2020

Hand (New York, N,Y.)

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Background: Medical malpractice accounts for more than $55 billion of annual health care costs. Updated malpractice risk to surgeons and physicians related to upper extremity peripheral nerve injury has not been published. Methods: A comprehensive database analysis of upper extremity nerve injury claims between 1995 and 2014 in the United States was conducted using the Medical Professional Liability Association Data Sharing Project, representing 24 major insurance companies. Results: Nerve injury in the upper extremity accounted for 614 (0.3%) malpractice claims (total of 188 323). Common presenting diagnoses included carpal tunnel syndrome (41%), upper extremity fractures (19%), and traumatic nerve injuries to the shoulder or upper limb (8%). Improper performance (49% of total claims) and claims without evidence of medical error (19%) were the most common malpractice suits. Orthopedic surgeons were the most frequently targeted specialists (42%). In all, 65% of nerve injury claims originated from operative procedures in a hospital, 59% of claims were dismissed or withdrawn prior to trial, and 30% resulted in settlements. Thirty-three percent of claims resulted in an indemnity payment to an injured party, with an average payout of $203 592 per successful suit. Only 8% of claims resulted in a completed trial and verdict, and verdicts were overwhelmingly in favor of the defendant (83%). Conclusions: Most malpractice claims from peripheral nerve injuries in the United States arise from the management of common diagnoses, occur in the operating room, and allege improper performance. Strategies to reduce malpractice risk should emphasize the management of common conditions and patient-physician communication.

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Section: Discussionmentioning

confidence: 99%

Medical Malpractice in Nerve Injury of the Upper Extremity

Krauss

Shankar

Patterson

et al. 2020

Hand (New York, N,Y.)

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“…8 Several articles have looked at NHSLA data for subspecialty areas of orthopaedic surgery, such as hand and wrist fractures and foot and ankle surgery, but no review to date has looked at patients with hip fractures. 9,10 These patients form a vulnerable and medically complex group who are especially prone to complications because of their compromised physiology. Our review demonstrates a significant number of claims relating to hip fractures, which carry an associated financial burden.…”

Section: Discussionmentioning

confidence: 99%

Hip fracture litigation: A 10-year review of NHS Litigation Authority data and the effect of national guidelines

Fanous

Sabharwal

Al‐Taie

et al. 2017

annals

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We present a review evaluating all litigation claims relating to hip fractures made in a 10-year period between 2005 and 2015. Data was obtained from the NHS Litigation Authority through a freedom of information request. All claims relating to hip fractures were reviewed. During the period analysed, 216 claims were made, of which 148 were successful (69%). The total cost of settling these claims was in excess of £5 million. The introduction of a best-practice tariff by the Department of Health in 2010 was designed to improve the quality of care for hip fracture patients. This was followed by guidance from the National Institute for Health and Clinical Excellence in 2011 and the British Orthopaedic Association in 2012. We analysed claims submitted before and after these guidelines were introduced and no significant difference in the number of claims was noted. The most common cause for litigation was a delay in diagnosis, which accounted for 86 claims in total (40%). Despite the presence of these guidelines and targets, there has not been a significant reduction in the number of claims or an improvement in diagnostic accuracy. This may be due to an increasing level of litigation in the UK but we must also question whether we are indeed providing best-practice care to our hip fracture patients and whether these guidelines need further review.

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“…A recent review of NHS Litigation Authority data from 1995 to 2012 revealed that wrist and scaphoid fractures together made up 36% of all claims pertaining to hand and wrist surgery, and that the leading reason for claims was “incorrect, missed, or delayed diagnosis.”10 A similar study looking specifically at the cost of successful claims related to scaphoid fractures between 1995 and 2010 showed that, of 85 settled cases within the NHS over that period, 57 claims were brought for reasons of missed diagnosis 11…”

Section: Why Does This Matter?mentioning

confidence: 99%