RESUMO
OBJECTIVE: Since insight into the reason for filing claims after treatment of varicose veins of the lower extremity might help prevent future claims, we determined the incidence of and reasons for medical liability insurance claims after such treatments in the Netherlands. METHOD: We performed a retrospective review of all medical liability insurance claims after varicose vein treatment handled by MediRisk between January 1993 and December 2007. RESULTS: A total of 144 claims were filed of which 104 were closed by the end of the study period. Nerve injury (n = 28), skin necrosis following sclerotherapy (n = 17), deep vein injury (n = 11) and insufficient communication (n = 9) accounted for more than 60% of all claims. Claims were equally distributed among registrars and consultants. Some 41 of the 104 closed claims were accepted. In 27 of the accepted cases, the physician had obviously failed in providing the care as expected from a medical practitioner allowed to perform these treatments. The majority of these 27 claims were due to injury of nerves (n = 11) or deep veins (n = 9). CONCLUSION: The incidence of claims after treatment of varicose veins in the Netherlands is low. Proper knowledge of anatomy and adequate communication, along with the introduction of less invasive treatments might prevent future claims.
Assuntos
Seguro de Responsabilidade Civil , Responsabilidade Legal , Erros Médicos , Escleroterapia/efeitos adversos , Varizes/terapia , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Humanos , Incidência , Países Baixos/epidemiologia , Traumatismos dos Nervos Periféricos/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico , Varizes/epidemiologia , Lesões do Sistema Vascular/epidemiologiaRESUMO
We analysed hand and wrist injury and disorder related liability claims in the Netherlands to identify causes and to contribute to the prevention of such claims. Data was collected from 743 hand and wrist claims filed between 1993 and 2007. Consultants were involved in 417 claims (56.1%). Treatment in the emergency department (ED) accounted for 64.9% of these 287 claims involved residents (59.5%). The majority of accepted claims in the ED included treatment by general surgeons (89.2%). The percentage of accepted claims was highest in the general surgery group (26.4%). Of accepted claims in the ED which involved a resident, 93.2% involved a general surgery resident. Better training and supervision is indicated. This paper supports hand injury treatment by adequately trained surgeons and preferably, where possible, by a trained hand surgeon.
