Medical liability claims in gynaecologic care: retrospective analysis of claims related to gynaecology in the Netherlands (2005-2022) - Is there a connection between treatment indication, phase of treatment and the risk of medical malpractice claims?

Désirée Klemann*, Rankie Ten Hoopen, Helen Mertens, Frits van Merode

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: An increased interest in medical liability claims has been noticed. Nevertheless, detailed data on subject of claims and possible factors that contribute to litigation and indemnity payments are scarce and relatively dated. Insight into these data may provide valuable information to prevent both incidents and malpractice claims. OBJECTIVE: To analyse the subject, outcome and costs of malpractice claims related to gynaecological care and their connection with treatment indications and treatment phases. DESIGN: A retrospective analysis of malpractice claims related to gynaecology. SETTING: All claims related to gynaecology, filed and closed by Netherlands' largest liability insurance company, Centramed between 2005 and 2022. SAMPLE: N = 382. METHODS: An in-depth analysis of claim files was performed. RESULTS: A total of 68.6% of the claims were related to perioperative incidents. A total of 88.0% of all claims were related to treatments with a benign indication and only 12.0% were related to malignancies. The share of malignant treatment indications was high for claims related to diagnostic incidents (37.9%), compared to 7.3% for claims related to surgical treatment. Liability was accepted in 22.5% of all claims. The total costs of all claims amount €6,6mlj. Besides the indication for treatment, deficient expectation management (a lack of informed consent) contributes to dissatisfaction and increases the risk of malpractice claims. Finally, an inadequate medical file compromises legal defence and influences the judgement and settlement of malpractice claims. CONCLUSIONS: There is a connection between treatment indications and treatment phases and the risk of malpractice claims and their outcome.
Original languageEnglish
Article number1465
Number of pages9
JournalBMC Health Services Research
Volume24
Issue number1
DOIs
Publication statusPublished - 25 Nov 2024

Keywords

  • File management
  • Gynaecology and obstetrics
  • Incident
  • Indemnity payment
  • Informed consent
  • Litigation
  • Malpractice claims
  • Surgical treatment
  • Treatment indications
  • Treatment phase
  • Humans
  • Malpractice/legislation & jurisprudence economics statistics & numerical data
  • Netherlands
  • Retrospective Studies
  • Female
  • Liability, Legal/economics
  • Gynecology/legislation & jurisprudence economics
  • Insurance Claim Review
  • Insurance, Liability/economics legislation & jurisprudence

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