title: A Swiss anaesthesiology closed claims analysis: report of events in the years 1987-2008.
abstract: OBJECTIVE
  In 1999, the Swiss Society of Anaesthesiology and Reanimation (SSAR) initiated an analysis of closed malpractice claims filed against anaesthetists in a project intended to improve patient safety. This article discusses the results of a review of closed claims between 1987 and 2008 and filed up to the end of 2009.
  
  
  METHODS
  Records of closed claims were provided by Swiss professional medical liability insurance companies and the Office for Extrajudicial Expert Review of the Swiss Medical Association. Data were collected by an onsite reviewer, converted into a standardised format and sent to the SSAR Closed Claims Study Group.Assessment criteria employed by the committee were level of care (standard or substandard); severity of injury; appropriateness of patient information; and consent.
  
  
  RESULTS
  The records of 171 events leading to anaesthesia-related injuries were entered into the database. These injuries occurred within the period 1987-2008. The majority of claims (54%) were related to regional anaesthesia, with general anaesthesia accounting for 28% and other anaesthesia-related procedures for 18%. The quality of care was judged by the committee to be substandard in 55% of cases, and liability was accepted in 46% of all claims. Negative outcomes were death in 12% and permanent injury in 63% of the patients.
  
  
  CONCLUSIONS
  The closed claims analysis project enabled the SSAR to identify areas of high medicolegal risks to gain an insight into the causes of infrequent but potentially harmful events leading to anaesthesia-related injuries and, based on these data, to develop preventive strategies.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Regional Hospital, Männedorf, Switzerland. s.staender@spitalmaennedorf.ch
authors.forename: Sven
authors.initials: S
authors.lastname: Staender
authors.forename: Hansjuerg
authors.initials: H
authors.lastname: Schaer
authors.forename: François
authors.initials: F
authors.lastname: Clergue
authors.forename: Helmut
authors.initials: H
authors.lastname: Gerber
authors.forename: Thomas
authors.initials: T
authors.lastname: Pasch
authors.forename: Karl
authors.initials: K
authors.lastname: Skarvan
authors.forename: Beat
authors.initials: B
authors.lastname: Meister
mesh_terms: D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods; D000776:Anesthesiology / Q000592:standards / Q000706:statistics & numerical data*; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects*; D016208:Databases, Factual; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000777:Anesthetics