Insurance Claims for Wrong-Side, Wrong-Organ, Wrong-Procedure, or Wrong-Person Surgical Errors: A Retrospective Study for 10 Years

Abstract

Objective: Serious adverse events, such as wrong-side, wrong-organ, wrong-procedure, or wrong-person errors, still occur despite the implementation of preventative measures. In France, we describe the claims related to such errors based on the database from one of the main insurance companies.Methods: A retrospective analysis of claims declared between January 2007 and December 2017 to Relyens, a medical liability insurance company (Sham), was performed. Their database was queried using the following keywords: "wrong side," "wrong organ," and "wrong person."Results: We collected 219 claims (0.4% of the total claims). The main specialties involved were orthopedics (34% of cases), neurosurgery (14%), and dentistry (14%). The claims were related to wrong organ (44%), side (39%), identity (13%), or procedure (4%). Juridical entity involved were mainly public facility (69%), followed by private facility (19%) or private physician (10%). The mean number of annual claims made has decreased of 20% since the mandatory implementation of the checklist in 2010 (22 versus 17.5 events per year). The main risk factors identified according to the ALARM protocol were factor related to the team (87%) or to the task to accomplish (78%). A direct causal factor was involved in 20% of the files, the main one being the organization (43%) closely related to the medical file (36%). The settlement was performed by conciliation in 69% of the claim and in court in 30%. The compensation was higher during a court settlement.Conclusions: Wrong-side, wrong-organ, wrong-procedure, or wrongperson surgical errors are rare but fully preventable by the implementation of a safety culture.

Wrong-Site Surgery in Spain and Professional Liability Claims

“…The value of such a large and well-structured sample containing judicial and extrajudicial cases must be highlighted, which has allowed them to analyze a surprisingly long series of cases. We agree with the authors that this kind of surgical errors is rare but fully preventable by the implementation of a patient safety culture 1 . However, these types of surgical errors, although foreseeable, are present in all health care systems around the world, 2,3 and this fact indicates that, even relatively easy to prevent, we should continue to make efforts in this area.…”

“…Similarly to the French sample, it collects information from the main physician’s professional liability insurance company in Catalonia (>26,000 physicians insured) and provides medical evidence from research as a rich source of learning from error 5 . We analyzed the same period as the study by Vacheron et al 1 (2007–2017), and we found 43 cases, 39 related to wrong site surgery (including wrong side and wrong organ) and 4 to wrong procedure. Unfortunately, our database does not include recorded cases of wrong person in surgical errors.…”

“…As in the article by Vacheron et al, 1 the specialty most involved in CMAC’s sample was orthopedic surgery and traumatology with 21 cases and representing almost half of the total number of registered cases. Following far behind orthopedic surgery and traumatology are general surgery (5 cases), oral and maxillofacial surgery, stomatology and neurosurgery (3 cases), urology, plastic surgery (2 cases), and dermatology, pediatric surgery, and finally otorhinolaryngology (1 case).…”

“…W e would like to congratulate Vacheron et al 1 for their necessary global vision of malpractice litigation in wrong side, wrong organ, wrong procedure, and wrong person in surgical errors in France. The value of such a large and well-structured sample containing judicial and extrajudicial cases must be highlighted, which has allowed them to analyze a surprisingly long series of cases.…”

“…We agree with the authors that this kind of surgical errors is rare but fully preventable by the implementation of a patient safety culture. 1 However, these types of surgical errors, although foreseeable, are present in all health care systems around the world, 2,3 and this fact indicates that, even relatively easy to prevent, we should continue to make efforts in this area. Thus, these types of events are included in the lists of serious reportable events or never occurring events.…”