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Related Experiment Videos

Shoulder dystocia--malpractice or acceptable risk?

J A Skolbekken1

  • 1Department of Psychology, University of Tromsø, Norway.

Acta Obstetricia Et Gynecologica Scandinavica
|September 19, 2000
PubMed
Summary

Compensation decisions for medical injuries in Norway are inconsistent, particularly in shoulder dystocia cases. The study questions whether acceptable risks should be compensated, highlighting a divide between compensated and uncompensated outcomes.

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Area of Science:

  • Medical Law
  • Public Health Policy
  • Obstetrics

Background:

  • Norway introduced a new patient insurance system in 1988, aiming for an 'objectified' no-fault principle.
  • The system's application was questioned due to rules denying compensation for adequate medical intervention and acceptable risks.
  • This study investigates the practical application of these rules within the Norwegian system.

Purpose of the Study:

  • To examine the application of rules regarding compensation for medical interventions in Norway.
  • To analyze decision-making processes in cases where medical risk is deemed acceptable.
  • To assess consistency in compensation decisions for obstetrical events.

Main Methods:

  • An archival study of 41 shoulder dystocia cases closed between 1988 and 1997.
  • Selection criteria focused on shoulder dystocia as a frequent cause for acceptable risk decisions.
  • Analysis of case files to evaluate compensation decisions and underlying reasoning.

Main Results:

  • Erb's palsy was the most common injury; fatalities and brain injuries also occurred.
  • Compensation was awarded in 9 cases, while the remaining were denied due to acceptable medical risk.
  • Inconsistencies in decisions were noted, attributed to differing expert opinions on medical practice adequacy.

Conclusions:

  • The study raises concerns about the consistency of decisions in similar medical injury cases.
  • Shoulder dystocia is identified as a potentially acceptable risk due to prediction and prevention difficulties.
  • The decision to compensate for consequences of acceptable risks remains a political and economic issue, creating disparities in outcomes.

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