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Litigation in English rhinology

Published online by Cambridge University Press:  23 March 2015

A S Harris*
Affiliation:
Department of Otorhinolaryngology, Abertawe Bro Morgannwg University Health Board, Swansea, Wales, UK
S J Edwards
Affiliation:
Department of Otorhinolaryngology, Abertawe Bro Morgannwg University Health Board, Swansea, Wales, UK
L Pope
Affiliation:
Department of Otorhinolaryngology, Abertawe Bro Morgannwg University Health Board, Swansea, Wales, UK
*
Address for correspondence: Mr Andrew S Harris, Hazeldine, Hillside, Prestatyn LL19 9EN, Wales, UK E-mail: drewharris@doctors.org.uk

Abstract

Objective:

Litigation is a rising financial burden on the National Health Service. This study aims to show if litigation is increasing in rhinology and which procedures lead to the most claims.

Methods:

Ten years of data were obtained from the National Health Service Litigation Authority. Rhinology claims were examined for cost, injury, diagnosis and operation type.

Results:

Of the 123 rhinology claims identified, 52 per cent were successful. There was a 56 per cent increase in the average annual number of claims between the first half of the study period and the second (p = 0.0451). The commonest reasons for a claim were poor cosmesis (15.6 per cent) and lack of informed consent (14 per cent).

Conclusion:

The number of claims in rhinology increased over the study period. Most claims resulted from poor cosmetic outcome, lack of consent or recognised complications. It is suggested that enhanced communication and management of patient expectations could reduce litigation and improve patient satisfaction.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented at the ENT Wales Academic Meeting, 11 October 2013, Cardiff, Wales, UK.

References

1Dyer, C. NHS bill for compensation exceeds £1bn for the first time. BMJ 2012;345:e4638Google ScholarPubMed
2Eaton, L. Clinical negligence claims continue to rise, thanks to “no win no fee” deals. BMJ 2010;341:c4258Google Scholar
3Dyer, C. Government looks at ways to reduce the cost of NHS negligence claims. BMJ 2011;342:d1131Google Scholar
4Dyer, C. Suing the NHS: can the £1bn annual compensation bill continue? BMJ 2013;346:f978Google Scholar
5NHS Litigation Authority. About us. In: http://www.nhsla.com/AboutUs/Pages/Home.aspx [2 June 2013]Google Scholar
6Mathew, R, Asimacopoulos, E, Valentine, P. Toward safer practice in otology: a report on 15 years of clinical negligence claims. Laryngoscope 2011;121:2214–19Google Scholar
7Mathew, R, Asimacopoulos, E, Walker, D, Gutierrez, T, Valentine, P, Pitkin, L. Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010. Ann Otol Rhinol Laryngol 2012;121:337–40Google Scholar
8Nikoghosyan-Bossen, G, Hauberg, A, Homøe, P. Increased number of ear-nose-throat malpractice complaints in Denmark. Dan Med J 2012;59:A4321Google Scholar
9Lynn-Macrae, AG, Lynn-Macrae, RA, Emani, J, Kern, RC, Conley, DB. Medicolegal analysis of injury during endoscopic sinus surgery. Laryngoscope 2004;114:1492–5Google Scholar
10Dawson, DE, Kraus, EM. Medical malpractice and rhinology. Am J Rhinol 2007;21:584–90Google Scholar
11Markides, GA, Newman, CM. Medical malpractice claims in relation to colorectal malignancy in the NHS. Colorectal Dis 2013;16:4856Google Scholar
12Armstrong, J. The changing face of plastic surgery. MDU Journal 2011;27:18e20Google Scholar
13Svider, PF, Keeley, BR, Zumba, O, Mauro, AC, Setzen, M, Eloy, JA. From the operating room to the courtroom: a comprehensive characterization of litigation related to facial plastic surgery procedures. Laryngoscope 2013;123:1849–53Google Scholar
14Gorney, M. Claims prevention for the aesthetic surgeon: preparing for the less-than-perfect outcome. Facial Plast Surg 2002;18:135–42Google Scholar
15Sykes, JM. Managing the psychological aspects of plastic surgery patients. Curr Opin Otolaryngol Head Neck Surg 2009;17:321–5Google Scholar
16ENT UK. Surgery on the nose - septal surgery. In: https://entuk.org/ent_patients/nose_conditions/septal_surgery [30 September 2013]Google Scholar
17ENT UK. Functional endoscopic sinus surgery (FESS). In: https://entuk.org/ent_patients/nose_conditions/fess [30 September 2013]Google Scholar
18ENT UK. Surgery on the nose - rhinoplasty. In: https://entuk.org/ent_patients/nose_conditions/rhinoplasty [30 September 2013]Google Scholar
19Svider, PF, Kovalerchik, O, Mauro, AC, Baredes, S, Eloy, JA. Legal liability in iatrogenic orbital injury. Laryngoscope 2013;123:2099–103Google Scholar
20Patel, AJ, Morrison, CM. Opportunities to reduce plastic surgery claims through an analysis of complaints data. J Plast Reconstr Aesthet Surg 2013;66:455–9Google Scholar
21Medical Protection Society. Sinus surgery: damaged vision. In: http://www.medicalprotection.org/uk/case-reports-september-2013/sinus-surgery-damaged-vision [21 January 2015]Google Scholar
22Medical Protection Society. It's all about consent. In: http://www.medicalprotection.org/uk/case-reports-september-2013/it-is-all-about-consent [21 January 2015]Google Scholar
23General Medical Council. Consent: Patients and Doctors Making Decisions Together. London: GMC, 2008Google Scholar
24Department of Health. Reference Guide to Consent for Examination or Treatment. London: Health Sciences and Bioethics Division, 2009Google Scholar
25Moulton, B, Collins, PA, Burns-Cox, N, Coulter, A. From informed consent to informed request: do we need a new gold standard? J R Soc Med 2013;106:391–4Google Scholar
26McDonald, SE, Chadha, NK, Mills, RS. Changing practices in the consent process for nose and throat procedures: a three-year study. J Laryngol Otol 2008;122:1105–8Google Scholar
27Goodyear, PW, Anderson, AR, Kelly, G. How informed is consent in a modern ENT department. Eur Arch Otorhinolaryngol 2008;265:957–61Google Scholar
28Grewal, P. Survey of post-operative instructions after inguinal hernia repair in England in 2012. Hernia 2014;18:269–72Google Scholar
29Askari, A, Shergill, I. Patient information leaflets for extracorporeal shock wave lithotripsy: questionnaire survey. JRSM Short Rep 2012;3:35Google Scholar
30Shergill, I, Bahl, K, Farjad, M, Phipps, C, Fowlis, G. Patient information leaflets for transrectal ultrasound guided prostate biopsy: results of North Thames deanery survey. BMC Res Notes 2010;3:27CrossRefGoogle ScholarPubMed
31Stacey, D, Bennett, CL, Barry, MJ, Col, NF, Eden, KB, Holmes-Rovner, M et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2011;(5):CD001431Google Scholar
32The Health Foundation. MAGIC: Shared decision making 2013. In: http://www.health.org.uk/areas-of-work/programmes/shared-decision-making/sites/ [30 September 2013]Google Scholar
33Bark, P, Vincent, C, Jones, A, Savory, J. Clinical complaints: a means of improving quality of care. Qual Health Care 1994;3:123–32Google Scholar
34Vincent, C, Young, M, Phillips, A. Why do people sue doctors? A study of patients and relatives taking legal action. Lancet 1994;343:1609–13Google Scholar
35Bismark, M, Dauer, E, Paterson, R, Studdert, D. Accountability sought by patients following adverse events from medical care: the New Zealand experience. CMAJ 2006;175:889–94Google Scholar