Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery.
World Neurosurg. 2020 Dec 05;:
Authors: Otsuki K, Watari T
Abstract
BACKGROUND: Neurosurgery is a specialty at high risk for malpractice claims, which can be influenced by the quality and safety of care. Diagnostic errors have gained increasing attention as a potentially preventable problem. Despite the burden of diagnostic errors, few studies have analyzed diagnostic errors in the field of neurosurgery. Here we delineate the effect of diagnostic errors on malpractice claims involving a neurosurgeon.
METHODS: This is a retrospective study, using the national Japanese malpractice claims database, and includes cases closed between 1961 and 2017. To examine the effect of diagnostic errors in neurosurgery, we compared diagnostic error-related claims (DERCs) with non-DERCs in indemnity, clinical outcomes, and factors relating to neurosurgeons.
RESULTS: There were 95 closed malpractice claims involving neurosurgeons during the study period. Of these claims, 36 (37.9%, 95% confidence interval [CI]: 28.7%-47.9%) were DERCs. Death was the most common outcome in patients associated with DERCs. Wrong, delayed, and missed diagnosis occurred in 25 (69.4%; 95% CI: 53.1%-82.0%), 4 (11.1%; 95% CI: 4.4%-25.3%), and 7 (19.4%; 95% CI: 9.8%-35.0%) cases, respectively. The most common presenting medical condition in DERCs was stroke. Subarachnoid hemorrhage, accounting for 85.7% of stroke cases, led to 27.8% of the total indemnity paid in DERCs.
CONCLUSION: DERCs are associated with higher numbers of accepted claims and worse outcomes. Identifying diagnostic errors is important in neurosurgery, and countermeasures are required to reduce the burden on neurosurgeons and improve quality. This is the first study to focus on diagnostic errors in malpractice claims arising from neurosurgery.
PMID: 33290895 [PubMed - as supplied by publisher]
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