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. 2021 Sep;103(8):548-552.
doi: 10.1308/rcsann.2021.0102.

Malpractice litigation and spinal surgery in the National Health Service: a single tertiary-level centre perspective over 12 years

N A Quraishi  1 , A Shetaiwi  1 , D D'Aquino  1 , K Salem  1
Affiliations

Malpractice litigation and spinal surgery in the National Health Service: a single tertiary-level centre perspective over 12 years

N A Quraishi et al. Ann R Coll Surg Engl. 2021 Sep.

Abstract

Introduction: Medical malpractice litigation is a major concern for all spine surgeons. Our aim was to evaluate the incidence and burden of successful litigation relating to the management of spinal disorders over 12 years within a UK NHS tertiary-level spinal unit and compare these litigation costs with those of other specialties.

Methods: We obtained all data held by our claims department from its inception in January 2008 to December 2019. We also obtained costs for the total financial burden incurred by our Trust during this period.

Results: In total, there were 83 closed claims involving spinal pathologies. Over 80% of these comprised negligent surgery (n = 28, 34%), delay to diagnose/treat (n = 25, 30%) and negligent care (n = 18, 22%). The vast majority of claims were withdrawn without incurring any cost to the hospital (n = 59, 71%) and only 24 (29%) resulted in successful litigation for the claimant. The total cost of damages for these 24 successful claims was just over £8 million, including legal costs of £2.5 million, out of total litigation costs of £381 million over this period.

Discussion: Fewer than 30% of initial claims against a tertiary spinal surgical referral unit resulted in a successful financial outcome for the claimant. The total costs incurred were just over £8 million, with one-third apportioned to high legal costs, reflecting the complexity of resolving spinal litigation. Our entire legal expenses accounted for only 2% of the total legal bill paid by our hospital over a 12-year period.

Keywords: Claims; Legal costs; Spinal litigation; Spine.

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Figures

Figure 1
Figure 1
Pie chart showing the causal distribution of all closed claims (n = 83): delay to diagnose/treat (dark blue), negligent surgery (orange), negligent clinical care (grey), consent issue (yellow), never event (light blue) and undisclosed (green).
Figure 2
Figure 2
Pie chart comparisons of (a) withdrawn (n = 59) versus (b) successful cases (n = 24): delay to diagnose/treat (dark blue), negligent surgery (orange), negligent clinical care (grey), consent issue (yellow), never event (light blue) and undisclosed (green).
Figure 3
Figure 3
Graph showing trend for all 83 closed claims from 2008 to 2019
Figure 4
Figure 4
Total costs for all high-value, high-volume claims and spinal surgery
See this image and copyright information in PMC

References

    1. Casey AT. The ugly face of medical negligence: where has justice gone? Eur Spine J 2014; 23: S1–S3.10.1007/s00586-014-3230-1 - DOI - PMC - PubMed
    1. House of Commons. Managing the costs of clinical negligence in trusts. https://publications.parliament.uk/pa/cm201719/cmselect/cmpubacc/397/397.pdf (cited May 2019).
    1. Machin JT, Hardman J, Harrison Wet al. . Can spinal surgery in England be saved from litigation: A review of 978 clinical negligence claims against the NHS. Eur Spine J 2018; 27: 2693–2699.10.1007/s00586-018-5739-1 - DOI - PubMed
    1. Hutton M. GIRFT programme national specialty report. Spinal Services 2019. https://gettingitrightfirsttime.co.uk/wp-content/uploads/2019/01/Spinal-... (cited May 2019).
    1. Lay K. NHS spinal surgery errors cost a third of its budget. The Times, 2019. Retrieved from https://www.thetimes.co.uk/article/nhs-spinal-surgery-errors-cost-a-thir...

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