Hip Arthroplasty Malpractice Claims in the Netherlands: Closed Claim Study 2000-2012

Background and purpose — Patients in Sweden are insured against avoidable patient injuries. Prosthetic joint infections (PJIs) resulting from intraoperative contamination are regarded as compensable by the Swedish public insurance system. According to the Patient Injury Act, healthcare personnel must inform patients about any injury resulting from treatment and the possibility of filing a claim. To analyze any under-reporting of claims and their outcome, we investigated patients’ claims of PJI in a nationwide settingPatients and methods — The national cohort of PJI after primary total hip replacement, initially operated between 2005 and 2008, was established through cross-matching of registers and review of individual medical records. We analyzed 441 PJIs and the number of filed patients’ claims, with regards to incidence, outcome, and any national, sex-linked or socioeconomic differences.Results — We identified 329/441 (75%) patients with PJIs as non-claimants. 96% of the filed claims were accepted. 64 (57%) of claimants sustained permanent disability. 2 factors were found to statistically significantly reduce the odds of filing claims: patient’s age above 73 years and fracture as indication for surgery. There were no significant national, sex-linked, or socioeconomic differences.Interpretation — The incidence of patients’ claims of PJI is low but claims are usually accepted when filed. Healthcare personnel should increase their knowledge of the Patient Injury Act to inform patients about possibilities of eligible compensation.

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“… 2012 , Zengerink et al. 2016 ). To our knowledge, specific claim rates of THR after fracture have not been studied previously.…”

Section: Discussionmentioning

confidence: 99%

Patient claims in prosthetic hip infections: a comparison of nationwide incidence in Sweden and patient insurance data

et al. 2018

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“…Regarding the claim outcome, previous studies from the Netherlands have reported a settlement rate of 8–25% of claims [ 32 – 34 ]. This number was higher in our study (30.9%).…”

Section: Discussionmentioning

confidence: 99%

Claims in orthopedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis

Sanders

Wimmer-Boelhouwers

Dijt

et al. 2020

Eur J Orthop Surg Traumatol

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Background Orthopedic foot/ankle surgery is a high risk specialty when it comes to malpractice claims. This study aims to evaluate the incidence, characteristics and outcome of claims in this area. Methods This was a retrospective, 10-year claim analysis, with data from an anonymous database. Baseline claim/claimant characteristics were collected from all orthopedic foot/ankle-related cases. Results Of 460 claims in total, most were related to delay in/wrong diagnosis or to (complications of) elective surgical procedures. Whether a claim was settled was related to type of injury (fracture) and type of claim (diagnostic mistake). Median amount disbursed in settled claims was €12,549. Claim incidence did not increase over the years. Conclusion Missed fracture diagnosis and “failed”/disappointing results of elective surgical procedures were the most common causes for claims. Sufficient knowledge of missed (foot) fractures and clear communication/expectation management before elective procedures could help to improve quality of healthcare and patient satisfaction.

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“…As a matter of fact, such a powerful type of study is lacking among the current literature; nevertheless, hip arthroplasty malpractice claims are constantly growing. Sciatic nerve injury is one of the main sources for litigation after THA in the United States [ 22 , 23 ], accounting for 19.6% of all orthopaedics claims in the Netherlands [ 24 ]. Obviously, the large prevalence of case series and the methodological flaws of the retained articles impair the significance of this review; anyway, we judge that a systematic literature search is essential at present to outline the state of the art about postarthroplasty sciatic nerve palsies in view of the central role of this complication in the orthopaedics malpractice claims worldwide [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Sciatic Nerve Palsy following Total Hip Replacement: Are Patients Personal Characteristics More Important than Limb Lengthening? A Systematic Review

Fine

Romagnoli

Zaffagnini

et al. 2017

BioMed Research International

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Sciatic nerve palsies are rare but potentially devastating complications, accounting for more than 90% of neurologic injuries following total hip replacement. A systematic literature screening was carried out searching papers evaluating an exclusive population of postarthroplasty sciatic nerve palsies to ascertain (1) the influence of limb lengthening itself on sciatic nerve palsy, (2) the most important risk factors, (3) the long-term prognosis, and (4) the outcomes of different treatments. Fourteen manuscripts were finally included. The wide prevalence of retrospective case series decreased the global methodological quality of the retrieved papers. A hazardous lengthening threshold cannot be surely identified. Developmental dysplasia of the hip and previous hip surgeries are the most frequently recognized risk factors. Rate of full nerve function restoration approximates two-thirds of the cases, independently of the extent of initial neural damage. Poor evidences are available about the best treatment strategy. Well-structured multicentric prospective comparative studies are needed to substantiate or contrast the finding of this review. Anyway, since the onset of palsies is probably due to a combination of individual factors, risk of nerve damage and potential for nerve recovery should be evaluated on an individual basis.

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Hip Arthroplasty Malpractice Claims in the Netherlands: Closed Claim Study 2000-2012

Cited by 35 publications

References 18 publications

Patient claims in prosthetic hip infections: a comparison of nationwide incidence in Sweden and patient insurance data

Patient claims in prosthetic hip infections: a comparison of nationwide incidence in Sweden and patient insurance data

Claims in orthopedic foot/ankle surgery, how can they help to improve quality of care? A retrospective claim analysis

Sciatic Nerve Palsy following Total Hip Replacement: Are Patients Personal Characteristics More Important than Limb Lengthening? A Systematic Review

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