title: A nationwide descriptive study of obstetric claims for compensation in Norway.
abstract: OBJECTIVE
  To describe causes of substandard care in obstetric compensation claims.
  
  
  METHODS
  A nationwide descriptive study in Norway.
  
  
  METHODS
  All obstetric patients who believed themselves inflicted with injuries by the Health Service and applying for compensation.
  
  
  METHODS
  Data were collected from 871 claims to The Norwegian System of Compensation to Patients during 1994-2008, of which 278 were awarded compensation.
  
  
  METHODS
  Type of injury and cause of substandard care.
  
  
  RESULTS
  Of 871 cases, 278 (31.9%) resulted in compensation. Of those, asphyxia was the most common type of injury to the child (83.4%). Anal sphincter tear (29.9%) and infection (23.0%) were the most common types of injury to the mother. Human error, both by midwives (37.1% of all cases given compensation) and obstetricians (51.2%), was an important contributing factor in inadequate obstetric care. Neglecting signs of fetal distress (28.1%), more competent health workers not being called when appropriate (26.3%) and inadequate fetal monitoring (17.3%) were often observed. System errors such as time conflicts, neglecting written guidelines and poor organization of the department were infrequent causes of injury (8.3%).
  
  
  CONCLUSIONS
  Fetal asphyxia is the most common reason for compensation, resulting in large financial expenses to society. Human error contributes to inadequate health care in 92% of obstetric compensation claims, although underlying system errors may also be present.
authors.affiliation: Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway. stin-a2@online.no
authors.forename: Stine
authors.initials: S
authors.lastname: Andreasen
authors.forename: Bjørn
authors.initials: B
authors.lastname: Backe
authors.forename: Rolf Gunnar
authors.initials: RG
authors.lastname: Jørstad
authors.forename: Pål
authors.initials: P
authors.lastname: Oian
mesh_terms: D001720:Birth Injuries / Q000191:economics / Q000209:etiology; D035881:Compensation and Redress; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D019300:Medical Errors / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D009664:Norway; D009775:Obstetrics and Gynecology Department, Hospital / Q000331:legislation & jurisprudence* / Q000592:standards / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011644:Puerperal Disorders / Q000191:economics / Q000209:etiology; D058996:Quality Improvement; D059039:Standard of Care