Author Archives: Pancras Beck

The clinical negligence research in the US and the social resonance

A group of scientists from Johns Hopkins University, Baltimore, conducted a study to ascertain the real extent of medical negligence problem and see how often mistakes are made by medical workers. Experts say that more than 80,000 of such incidents occurred between 1990 and 2010. The researchers’ findings are based on data provided by the National Bank of the medical information that registers all the errors committed by doctors.

As it turned out, the error of doctors committed for various reasons, including because of negligence, are not really rare. Just imagine, an average of 39 cases  when in the course of operations doctor misses various facts are registered per week. But the severity of these violations is different, and significant damage is there: a doctor may leave an item inside the body, another patient may harm  the wrong part of the body. The cases in which the patients undergo operations on the wrong organs take place up to 20 times a week. The most common items that are removed from the bodies of patients are sponges and towels.

The fact that only in the United States alone there were more than 80,000 of such  accidents in the last twenty years shows that the scope of the issue, in fact, even more. If a person comes into the hospital complaining of feeling unwell, fixing a medical error is possible by removing foreign objects. But just think how many people live with some tools in the body and don’t even know about it. Of course, there is more likelihood that the surgeon may find out that an item was left inside earlier, then the issue is likely to be fixed sooner. Nevertheless, while in the US according to NPB publication 5% of patients suffer from clinical negligence, in the UK this number balances between 4-5% according to solicitors.guru, a prominent legal startup running a database of medical negligence solicitors, in such countries as Russia or Peru these numbers are not even officially tracked.

‘There are errors in health care that can not be avoided, no matter how hard you try. For example, even if you make every effort to prevent the spread of infection, it could be impossible. However, certain situations, such as the ones when the surgeon forgets a tool inside the body, should be reduced if not to zero, then at least to a minimum. Frankly speaking, this study and the figures that we have presented, is a direct proof of the fact that a lot of work has to be made to make medicine safer’, says the study’s lead author, Marty Makary MD.

Researchers believe that the magnitude of the problem under investigation should encourage physicians and regulatory authorities to develop a more effective system of control. For more than 20 years there has been 9744 cases of medical negligence, which resulted in $1.3 billion cost – the total amount of compensation to claimants.

According to experts, 6.6% of patients due didn’t survive after the errors, for 32.9% the case ended with a chronic disease; the amount of those who escaped with slight shock is 59.2%.

In addition, there are other surgical errors. For example, often the patients ‘treated’ wrong drugs, or given the wrong dose, women who enlisted the help of artificial insemination are inseminated with sperm of the wrong donor, people operate in the wrong place, where it is necessary, and it happens sometimes that a wrong person is lying on the operation table.

Clinical negligence practice across the globe: the stats and numbers

With the rising number of clinical negligence claims around the world the question of  when and who is expected to provide compensation in cases where the episodes of clinical negligence were found and confirmed. Whether it is going to be a provider of healthcare services or insurance company, the system of social insurance funds or some organisations funded by contributions of physicians and (or) patients, or the state.

To facilitate the growing burden of medical fees for insurance policies of professional responsibility the British government in 1990 introduced a national system of liability insurance that covers doctors (except family) and dentists working in hospitals and other medical institutions of public health sector. Under this system, compensation for damage is caused by medical intervention, paying those medical institutions employing doctors found guilty of causing damage. This increased control of the management of health care organisations over the work of staff. According to solicitors.guru, the legal platform gathering hundreds of medical negligence solicitors under one roof, the introduction of the process has significantly unloaded courts and positively affected the average hearing period.

As a rule, disputes over compensation for damages, suffered as a result of medical intervention, are resolved in court. It is always associated with a fairly complex and lengthy procedure of trial and emotional stress on the part of the patient (the plaintiff), and health worker (the defendant) and the administration of treatment of the organisation. The practice of law and forensic evaluation of adverse outcomes of medical care shows that in 33-58% of cases the patient’s dissatisfaction with medical care during the subsequent examination of medical assistance is assessed as adequate. The proportion of European medical practice in such cases ranges from 53 to 59%. At the same time, many of these incidents could have been avoided, keeping staff away from from unproductive conflict resolution in court and saving time for forensic on challenging commission assessment of the quality of care. High developed economies have long admitted the fact that the price of the complaint that goes beyond the clinic, starts to rise steadily, acquiring judicial, expert and other costs. For example, in the US the cost of a three-year trial on the complaint exceeds $13,000. In addition to the economic losses arising from the conflict in the area of health care, you cannot ignore the moral damage inflicted to both sides, which ultimately leads to higher prices and lower quality of care.

To assist the patients with proving that the cause of the damage is nothing but medical intervention a system of compensation for the damage suffered by the patient,  requiring no specific perpetrators and the evidence of their guilt, which is especially difficult for the victim, is widely utilised. It is based on the concept of liability without fault. For the first time such a system has been introduced in New Zealand in the early 70s, where it acts as a kind of social security. The concept comes from the fact that in some cases the damage to a patient during a medical intervention was not an episode of gross negligence or negligent actions of the medical staff, but may be explained by the unfavorable circumstances, unforeseen reaction of the patient and other unpredictable factors due to which the damage was caused.