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Patient injuries in response to anaesthetic procedures: cases evaluated by the Danish Patient Insurance Association
L D Hove1, H B Nielsen, J K Christoffersen
1Department of Anaesthesia, Gentofte Hospital and Rigshospitalet, University of Copenhagen, Denmark. larshove@dadlnet.dk
Background:
In response to medical treatment, side-effects may occur and the patient may be injured. In Denmark, a patient is entitled to raise a claim for financial compensation and the validity of the claim which, based on defined criteria, is decided by the independent Patient Insurance Association (PIA). In this study, we investigated the files of the patients who were given financial compensation because of an injury caused by an anaesthetic procedure. We wanted to find the sort of injuries and the anaesthetic procedures involved and the size of financial compensation.
Methods:
A retrospective study of the PIA database from 1996 to 2002 concerning the speciality anaesthesiology.
Results:
From 1996 to 2002, 18,917 patients made a claim and out of these 916 files were related to anaesthetic procedures, of which 374 cases resulted in financial compensation. In the same period, it is estimated that the total number of anaesthetic procedures was approximately 400,000 per year in Denmark. The primary causes for financial compensation were nerve lesions in response to regional anaesthesia (epidural, spinal, peripheral nerve blockade; n = 132), body positional-related injuries (n = 100), complications due to intravascular catheters or needles (n = 39) and teeth damage during airway handling (n = 31). After anaesthesia, 12 patients' brain functions were impaired probably as a result of prolonged peri-operative hypotension and hypoxaemia. Death occurred in 21 cases. The average financial compensation was 21,500 euros (0.3% of the total amount from all cases) and in 13 cases the injury induced severe patient disability and therefore the compensation was above 1 million DKr. equal to 150,000 euros.
Conclusion:
In the 6-year period 1996-2002, 374 patients were given in total 8.0 million euros in financial compensation for an injury caused by an anaesthetic procedure. Some anaesthetic complications may result in severe disability whereby the financial compensation to the suffering patients is high. In this study, we estimate that approximately approximately 0.2 per thousand of all patients receiving anaesthesia may develop complications that entitle them to financial compensation.
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