Neurosurgery and litigation: An observational study of liability for damages in public neurosurgical practice in Spain

Abstract

Background and objectiveNeurosurgery has been internationally considered a “high risk” specialty for lawsuits. The aim of this observational study was to analyse the characteristics of medical liability judgements in Spain for damages caused by the practice of neurosurgery in Spanish public healthcare. Materials and methodsCross-sectional observational study analysing the rulings handed down in the contentious-administrative jurisdiction by the High Courts of Justice in the period 2008–2020, in the specialty of neurosurgery. The variables were administrative, clinical, judicial, and compensatory. ResultsA total of 1015 rullings were analysed, of which 38 (3.74%) were related to neurosurgery. A total of 51.85% of the judgements were dismissed at first instance and 88.88% at second instance. The most frequent reason in the judgements upholding the compensation requested by the patients was lack of information: 8 (53.33%). The most frequently claimed damage was sequelae: 31 (81.57%). The medical activity most related to the claims was spinal surgery: 23 (60.52%). The median award was 40 000 euros, with a range of 5000–78 285 euros. ConclusionsIn the Spanish public health system, the specialty of neurosurgery is not among the most demanded. Most of the rullings (60%) reject the compensation requested and, therefore, are favourable to the health services. In the case of an upheld decision, lack of information is the most frequent reason for breach of the lex artis. These data contribute to improving the knowledge of professionals in the medical-legal aspects of healthcare and invite the formulation of further studies contrasting the Spanish data with those of other countries.