title: Financial compensation for radiotherapy-related adverse events in a judicial system where proof of medical negligence is not required.
abstract: OBJECTIVE
  To examine the frequency of adverse events related to radiation therapy that lead to financial compensation in a judicial system that is not based on litigation in court but on statutory insurance where proof of medical negligence is not required for obtaining compensation.
  
  
  METHODS
  In Finland, an injured patient does not sue through the courts, but submits an insurance claim to the Patient Insurance Association. Proof of medical negligence is not required for obtaining compensation. We reviewed all filed claims associated with radiotherapy presented to the Patient Insurance Association from May 1987 to January 1999. During this time period, 1,732,000 patient visits to radiation therapy units were made, and the estimated number of radiotherapy treatments was 86,600. The data collected included descriptions of the adverse events, examination of the radiation therapy procedures followed, assessment of the causal relation of the event to radiotherapy by the therapists involved and by independent reviewers, and the sums used for compensation.
  
  
  RESULTS
  Only 102 patients (about 0.1%) had filed a claim for financial compensation, and in 18 (0.02%) cases the claim led to compensation. The mean national annual expenditure used for compensation was $35,200, and the sums paid in single cases ranged from $310 to $287,430 (median, $1,970). The expenditure used for compensating adverse radiation events was about $4 per treated patient, which is about 0.3% of all radiation therapy costs.
  
  
  CONCLUSIONS
  The frequency of radiation therapy injuries that are financially compensated can remain low in an insurance-based judicial system where no litigation or attorneys are involved.
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland. paul.nyandoto@hus.fi
authors.forename: P
authors.initials: P
authors.lastname: Nyandoto
authors.forename: T
authors.initials: T
authors.lastname: Muhonen
authors.forename: T
authors.initials: T
authors.lastname: Hakala
authors.forename: M P
authors.initials: MP
authors.lastname: Dombrowski
authors.forename: H
authors.initials: H
authors.lastname: Joensuu
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005387:Finland; D006801:Humans; D016365:Liability, Legal / Q000191:economics*; D008297:Male; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications / Q000191:economics; D011878:Radiotherapy / Q000009:adverse effects* / Q000706:statistics & numerical data