Abstract
Introduction: There are risks attached to performing hand surgery and not just due to the fact that there are many important structures in a compact area, but because of increasing litigation. To date the cost of litigation is unknown. We have reviewed NHSLA data for closed litigation claims from 1995–2001.
Method: NHSLA provided data detailing litigation claims and settlements for orthopaedic hand problems. Data sets include: incident date, creation date, incident details, damages paid, defence costs, claimant costs, total claim, cause, injury location, speciality. We analysed the data with respect to: A& E, inpatients, out-patients department and surgery to understand where most claims were made and subsequent costs.
Results: There is a clear trend of increasing numbers of litigation cases, successful claims and settlement amounts. The clinical areas making the most claims and resulting in the greatest costs are: 1-Surgery, 2-Outpa-tients, 3-A& E, 4-Inpatients and lastly 5-Administration. The top 5 pathologies claimed for are: 1-wrist fracture, 2-carpal tunnel release, 3-ganglion excision, 4-metacarpal fracture, and 5-missed scaphoid fractures.
Conclusion: This data is very interesting as litigation is a very emotive and sensitive issue. We confirm that litigation is on the rise and needs to be addressed. It’s evident that the majority of claims involve routine procedures or routine management decisions. Of note there are no cases relating to more complex hand surgery or difficult management issues.
Correspondence should be addressed to David Bracey, Honorary Secretary c/o Royal Cornwall Hospitals Trust, Truro, Cornwall TR1 3LJ
