Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients

Joachim Horn; Hanne Rasmussen; Ida Rashida Khan Bukholm; Olav  Røise; Terje Terjesen

doi:10.1080/17453674.2021.1932922

Authors

Joachim Horn Division of Orthopaedic Surgery, Section of Children’s Orthopaedics and Reconstructive Surgery, Oslo University Hospital; Institute of Clinical Medicine, University of Oslo, Oslo
Hanne Rasmussen Department of Orthopaedics, University of Northern Norway
Ida Rashida Khan Bukholm The Norwegian System of Patient Injury Compensation; The Norwegian University of Life Science
Olav Røise Division of Orthopaedic Surgery, Section of Children’s Orthopaedics and Reconstructive Surgery, Oslo University Hospital; Institute of Clinical Medicine, University of Oslo, Oslo; University of Oslo and Faculty of Health Sciences, SHARE – Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
Terje Terjesen Division of Orthopaedic Surgery, Section of Children’s Orthopaedics and Reconstructive Surgery, Oslo University Hospital

DOI:

https://doi.org/10.1080/17453674.2021.1932922

Abstract

Background and purpose — In Norway all compensa- tion claims based on healthcare services are handled by a government agency (NPE, Norsk Pasientskade Erstatning). We provide an epidemiological overview of claims within pediatric orthopedics in Norway, and identify the most common reasons for claims and compensations.

Patients and methods — All compensation claims handled by NPE from 2012 to 2018 within pediatric ortho- pedics (age 0 to 17 years) were reviewed. Data were ana- lyzed with regard to patient demographics, diagnoses, type of injury, type of treatment, reasons for granted compensa- tion, and total payouts.

Results — 487 compensation claims (259 girls, 228 boys) within orthopedic surgery in patients younger than 18 years at time of treatment were identified. Mean age was 12 years (0–17). 150 out of 487 claims (31%) resulted in compensa- tion, including 79 compensations for inadequate treatment, 58 for inadequate diagnostics, 12 for infections, and 1 based on the exceptional rule. Total payouts were US$ 8.45 million. The most common primary diagnoses were: upper extremity injuries (26%), lower extremity injuries (24%), congenital malformations and deformities (12%), spine deformities (11%), disorders affecting peripheral joints (9%), chondrop- athies (6%), and others (12%).

Interpretation — Most claims were submitted and granted for mismanagement of fractures in the upper and lower extremity, and mismanagement of congenital malfor- mations and disorders of peripheral joints. Knowledge of the details of malpractice claims should be implemented in edu- cational programs and assist pediatric orthopedic surgeons to develop guidelines in order to improve patient safety and quality of care.