Abstract
Large scale databases that offer a reflection of clinical negligence are rare. By assessing commonly occuring cases of negligence, we hope to highlight areas where pediatric orthopedic care might be improved. One such database is the National Health Service Litigation Authority, which deals with claims brought against all health trusts in England. By collating their data we aimed to highlight areas of commonly occurring clinical negligence and then suggest ways to avoid similar happening again. We reviewed all cases pertaining to pediatric orthopedic claims between 1995 to 2006 as provided by the NHSLA. Of those considered in our study (341), by far the most common cause of litigation is missed or incorrectly diagnosed injuries/ conditions-accounting for 57% of all cases. 44% of those are upper limb injuries, mainly fractures around the elbow. Misdiagnosed disorders of the hip such as hip dysplasia and SCFE also represent a frequent reason for litigation (11%). Other common causes are poor plaster application and removal (7.3%) and non-surgical site specific errors such as chemical burns from skin prep. Although specific to the English system, these findings are likely to mirror that found in other countries. Highlighting these commonly occurring errors, better education of doctors in targeted areas and due care in simple procedures may have significant improvement of child orthopedic care.
Highlights
There were well over 7,000,000 elective and trauma orthopaedic procedures performed between 1995 and 2006 in the UK
We reviewed all cases pertaining to pediatric orthopedic claims between 1995 to 2006 as provided by the NHS Litigation Authority (NHSLA)
Of those considered in our study (341), by far the most common cause of litigation is missed or incorrectly diagnosed injuries/ conditions—accounting for 57% of all cases. 44% of those are upper limb injuries, mainly fractures around the elbow
Summary
There were well over 7,000,000 elective and trauma orthopaedic procedures performed between 1995 and 2006 in the UK. Compared to the number of cases performed, the frequency of successful litigation is relatively low but is financially costly to the National Health Service (NHS). In 2007/2008, a total of over £65 million was paid by the NHS Litigation Authority (NHSLA) in all orthopaedicrelated settlements. The numbers of cases brought to successful litigation are scarce. The costs both financially and emotionally to patients is high. The NHSLA was established on 20th November 1995 to indemnify English NHS bodies against claims for clinical negligence. As such, it is a Special Health Authority and part of the English NHS. Its sole function is to administer the ‘‘Clinical Negligence Scheme for Trusts’’ (CNST), a risk-pooling scheme in respect of clinical claims arising from incidents on or after 1st April 1995 [1]
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