W B Campbell1, F France, H M Goodwin. 1. Vascular Surgical Society of Great Britain and Ireland, Royal College of Surgeons of England, London, UK.
Abstract
BACKGROUND: Knowledge about medicolegal claims is important for risk management and clinical practice. This study presents the first comprehensive collated data for vascular surgical practice. METHOD: Details of claims notified to the National Health Service Litigation Authority (NHSLA) since its inception in 1995, and to the Medical Defence Union (MDU) from 1990-1999 were analysed. RESULTS: A total of 424 claims were notified--170 NHSLA and 254 MDU (176 from surgeons who described themselves as 'vascular' and 248 from 'general surgeons'). Varicose veins were the commonest condition involved (244 claims) and nerve damage was the most frequent complaint (76), followed by incorrect or unsatisfactory surgery (35), and damage to the femoral vein (16) or artery (13). Arterial claims (174) against vascular surgeons comprised 88% in the NHS but only 39% in private practice: 45 related to aortic grafting, 28 to other bypass grafts, and 36 alleged failure to recognise or treat ischaemia. CONCLUSIONS: The likely cause of many of these claims was failure to advise patients about potential risks and expected benefits. Recognition of the areas of highest risk, with improvements in communication and record keeping, may limit future claims.
BACKGROUND: Knowledge about medicolegal claims is important for risk management and clinical practice. This study presents the first comprehensive collated data for vascular surgical practice. METHOD: Details of claims notified to the National Health Service Litigation Authority (NHSLA) since its inception in 1995, and to the Medical Defence Union (MDU) from 1990-1999 were analysed. RESULTS: A total of 424 claims were notified--170 NHSLA and 254 MDU (176 from surgeons who described themselves as 'vascular' and 248 from 'general surgeons'). Varicose veins were the commonest condition involved (244 claims) and nerve damage was the most frequent complaint (76), followed by incorrect or unsatisfactory surgery (35), and damage to the femoral vein (16) or artery (13). Arterial claims (174) against vascular surgeons comprised 88% in the NHS but only 39% in private practice: 45 related to aortic grafting, 28 to other bypass grafts, and 36 alleged failure to recognise or treat ischaemia. CONCLUSIONS: The likely cause of many of these claims was failure to advise patients about potential risks and expected benefits. Recognition of the areas of highest risk, with improvements in communication and record keeping, may limit future claims.