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

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 wrong-person surgical errors are rare but fully preventable by the implementation of a safety culture.

Clinical Safety Recommendations for Testicular Torsion: Analysis of 101 Claims Settled with Compensation in Spain and France.

INTRODUCTION: The study aimed to analyze testicular torsion (TT) claims settled with compensation to have data available as the basis for making recommendations to decrease clinical risk and prevent claims. TT is a urological emergency with a high rate of orchiectomy, representing one of the main reasons for urological claims. METHODS: Data were analyzed from personal majority policy and from the public sector of Catalonia (Spain), as well as data from the main medical civil liability insurance firm at healthcare centers in France in the period from January 1, 2000 to December 31, 2018. RESULTS: Fifty Spanish and 51 French cases were analyzed. Statistical differences were logged in the two settings analyzed in performing ultrasounds, in the area where primary care was provided and with regard to settlement amounts. Diagnosis was late in 76.2% of cases. DISCUSSION: The medical action time from the onset of symptoms and Doppler testicular ultrasound in cases of questionable differential diagnoses is key to prognoses to save the testicles. Properly filling out the emergency report and the rest of medical records are essential for receiving correct medical care and defending possible claims.

Análisis de las reclamaciones por presunta responsabilidad profesional médica relacionadas con la mastopexia / Analysis on claims based on alleged medical professional liability related to mastopexy

Introducción: La mastopexia es uno de los actos más comunes en cirugía estética, constituyendo asimismo una de las causas de litigiosidad más creciente en los últimos años. Material y métodos: Se revisaron las sentencias de audiencias provinciales del periodo 2010-2018 y se analizaron las reclamaciones de la casuística del Consell de Col·legis de Metges de Catalunya entre el año 2009 al 2018 relativas a la mastopexia. Resultados: Se obtuvieron 50 sentencias en las que la mayoría de las reclamaciones se basaron en un defecto de información y/o mala praxis técnica. En 26 casos se desestimaron las pretensiones de la actora. La media del quantum indemnizatorio en las 24 resoluciones condenatorias fue de 22.583 euros. El análisis de casuística objetivó 28 reclamaciones relativas a mastopexia, siendo extrajudiciales en 17 casos, civiles en 7 y penales en 4. La media de cuantía reclamada en vía civil fue de 47.551,24 euros y la indemnizada fue de 30.734,32 euros. Discusión: El número de resoluciones se ha mantenido estable en el periodo estudiado. El defecto de información, así como la estimación jurídica de una obligación de medios o de resultados es clave en este tipo de reclamaciones. Existe una notable diferencia entre el quantum reclamado y el indemnizatorio en los casos de condena

Introduction: Mastopexy is one of the most common aesthetic procedures, and is also one of the causes of increased litigation in the past few years. Material and methods: 50 Provincial Court judgements were checked in the period between 2010 and 2018, as well as claims made to the Professional Liability Service of the Catalonian Colleges of Physicians between 2009 and 2018 regarding mastopexy. Results: Most of the 50 judgements were based on an information defect and/or technical malpractice. In 26 cases all claims were dismissed. The compensation average in the 24 condemnatory judgements was 22.583 Euros. The case study analysis revealed 28 complaints regarding mastopexy, 17 were out-of-court claims, 7 civil, and 4 criminal. The average amount claimed in civil proceedings was 47,551.24 Euros, while the average compensation was 30,734.32 Euros. Discussion: The number of resolutions remained stable over the studied period. The lack of information as well as the judicial recognition of an obligation of means or results is essential in these types of claims. There is a notable difference between the amount claimed and the compensation in the cases of conviction