Is failure to provide venous thromboprophylaxis negligent?
OBJECTIVE
To report the outcome of 100 consecutive medicolegal claims referred to one of the authors (1990-2003) following the development of venous thromboembolism (VTE) in surgical patients.


METHODS
A retrospective analysis of the experience of a vascular surgeon acting as an expert witness in the United Kingdom.


RESULTS
Prophylaxis had been provided to 43 claimants with risk factors, who, unfortunately, still developed a VTE and alleged negligence. Twenty-nine claims involved patients who had not received prophylaxis because they were at low risk. In 25/28 claims where no prophylaxis was provided, despite identifiable VTE risk factors, the claim was successful. Claimants who developed a VTE that had been managed incorrectly were successful whether they had received prophylaxis or not. Settlement amounts, where disclosed, are reported.


CONCLUSIONS
Failure to perform a risk assessment and to provide appropriate venous thromboprophylaxis in surgical patients is considered negligent. Clinicians looking after all hospitalized patients who are not assessing their patients' risk for VTE and/or not providing appropriate prophylaxis are at risk of being accused of negligence.
Scurr
J R H
JR
Royal Liverpool University Hospital, Liverpool, UK. scurrj@hotmail.com
Scurr
J H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000592:standards*; D006113:United Kingdom; D054556:Venous Thromboembolism / Q000191:economics / Q000517:prevention & control*