Pediatric neurosurgery malpractice claims in Germany
There is limited data regarding malpractice claims in pediatric neurosurgery. Aim of this study was to analyze the rate, subject, and outcome of malpractice claims faced by pediatric neurosurgeons.
We analyzed malpractice claims in pediatric neurosurgical patients assigned to the review board of North Rhine Medical Council from 2012 to 2016. Claims were categorized as “medical error” or “adverse event, no medical error.” Severity was graded from negligible (grade 1) to death (grade 6).
Of 391 pediatric malpractice claims, seven (1.8%) concerned pediatric neurosurgery. Claims were related to cranial surgery (N = 5), spinal surgery (N = 1), and a neuro-interventional procedure (N = 1). Of operative cases, three were shunt operations, two were cranioplasty procedures, and one was a spinal fusion. Complications of medical care (adverse events) had occurred in all cases. A medical error was detected in only one case. Severity of damage was grade 2 (transient minor) in three, grade 3 (transient major) in one, and grade 5 (permanent major) in three cases, respectively.
Pediatric neurosurgery accounted for 1.8% of all pediatric malpractice claims. In 14% of these claims, a medical error was confirmed. Malpractice claim rate thus appears to be lower than expected for a high-risk specialty. , adverse events were confirmed in all cases, a negligent medical error was rare. Adverse event rate appears to be a predictor for malpractice claim burden, highlighting the importance of surgical checklists, standard operating procedures and morbidity and mortality surveillance.
KeywordsMedical error Adverse event Litigation Children
Compliance with ethical standards
Conflict of interest
The authors report no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
- 4.Grober ED, Bohnen JMA (2005) Defining medical error. Can J Surg 48:39–44Google Scholar
- 5.Drake JM, Riva-Cambrin J, Jea A, Auguste K, Tamber M, Lamberti-Pasculli M (2010) Prospective surveillance of complications in a pediatric neurosurgery unit. J Neurosurg Pediatr 5:0–544. doi: https://doi.org/10.3171/2010.1.PEDS09305,
- 10.Scheppokat KD, Neu J (2007) Medical data and quality management. Dtsch Arztebl Int 104:A-3172Google Scholar
- 12.Pukk-Härenstam K, Ask J, Brommels M et al (2008) Analysis of 23 364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons learned from Sweden. Qual Saf Health Care 17:259–263. https://doi.org/10.1136/qshc.2007.022897 Google Scholar
- 13.Bundesärztekammer (2015) Statistische Erhebung der Gutachterkommissionen und Schlichtungsstellen für das Statistikjahr 2015Google Scholar
- 15.Landriel Ibañez FA, Hem S, Ajler P et al A new classification of complications in neurosurgery. World Neurosurg 75:709–15–11. https://doi.org/10.1016/j.wneu.2010.11.010
- 16.Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA, Safe Surgery Saves Lives Study Group (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499. https://doi.org/10.1056/NEJMsa0810119 CrossRefGoogle Scholar
- 19.Amare G (2012) Reviewing the values of a standard operating procedure. Ethiop J Health Sci 22:205–208Google Scholar
- 20.Nachtigall I, Tafelski S, Günzel K, Uhrig A, Powollik R, Tamarkin A, Wernecke KD, Spies C (2014) Standard operating procedures for antibiotic therapy and the occurrence of acute kidney injury: a prospective, clinical, non-interventional, observational study. Crit Care 18:R120. https://doi.org/10.1186/cc13918 CrossRefGoogle Scholar
- 21.Reason J (1997) Managing the risks of organizational accidents, First Edit. Ashgate Publishing LimitedGoogle Scholar