Iatrogenic Nerve Injuries Affecting Upper Limb Function: Medicolegal Implications

Nerve injuries are among the commonest iatrogenic complications and most frequently are the result of direct intraoperative damage causing serious distress and long-term morbidity. Additionally, they can add a considerable financial burden to health care systems, while they constitute a well-known source of medicolegal implications. There are few published articles addressing the medicolegal consequences of the iatrogenic nerve injuries affecting upper limb function. Our aim was to identify malpractice claims related to iatrogenic nerve injuries affecting upper limb function and to define the reasons of successful litigations.

This is a retrospective study of all malpractice claims concerning iatrogenic nerve injuries related to upper limb function, which ended in a trial in a European country, within a 20-year period (2000-2019). The data were obtained from the archives of the Council of State of the country and were further analyzed to identify the number of claims related to iatrogenic nerve injuries affecting the function of the upper limb.

In total, there were 13 cases associated with the brachial plexus (6), spinal accessory (3), median (1), radial (1), and digital nerves (2). The injuries were related to upper limb or neck surgery and to vaginal deliveries, most complicated with shoulder dystocia. Eight cases closed in favor of the plaintiff, three in favor of the defendant, while two remained still open, at the time the study was conducted. The mean indemnity payment was €67.634 (€10.000-201.697), with the highest payments set for cases that required further operative reconstruction.

Negligence claims are increasing worldwide, with a considerable impact on health systems and involved surgeons. Identifying the reasons for successful litigations will help surgeons take necessary preventive measures to minimize implications.

Observational IV.