title: Medical malpractice claims in relation to colorectal malignancy in the national health service.
abstract: OBJECTIVE
  Under the current increased financial constraints affecting the National Health Service (NHS), clinical negligence claims and associated compensations are constantly rising. Our aim was to identify the magnitude, trends and causes of malpractice claims in relation to a common pathology such as colorectal malignancy in the NHS.
  
  
  METHODS
  Data requests were submitted to the NHS Litigation Authority (NHSLA) and to the Medical Defence Union (MDU) and Medical Protection Society (MPS). Data were reviewed, categorized clinically and analysed in terms of causes and costs behind claims.
  
  
  RESULTS
  Data from the MPS and MDU were unavailable. In all, 169 claims were identified from the NHSLA database between 2003 and 2012; 123 (73%) cases had been closed, 80 (65%) of which were successful. An increasing overall claim frequency and success rate were found over the last few years. Total litigation expenses were £8.6 million, with 39% paid out as legal expenses. The commonest cause of complaint in successful claims was in relation to diagnostic delays or failures (58%, £5.1 million), with a delay or failure by the clinician to take action in response to an abnormal investigation result being a major factor. The occurrence of peri-operative complications (20%, £1.6 million) was the second commonest cause.
  
  
  CONCLUSIONS
  Average frequency and success rates of malpractice claims in secondary care in the NHS are rising, leading to significant overall payouts. The failure or delay in diagnosing colorectal malignancy or its postoperative complications is a common cause behind malpractice claims. Improvement in these areas could enhance patient care and reduce future claims.
authors.affiliation: Department of General Surgery, Huddersfield Royal Infirmary, Huddersfield, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Markides
authors.forename: C M
authors.initials: CM
authors.lastname: Newman
mesh_terms: D003082:Colectomy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000628:therapy; D035881:Compensation and Redress; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D057210:Delayed Diagnosis / Q000191:economics / Q000706:statistics & numerical data; D003951:Diagnostic Errors / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007431:Intraoperative Complications / Q000191:economics / Q000453:epidemiology; D008318:Malpractice / Q000191:economics / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D013222:State Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006113:United Kingdom
keywords: Colorectal malignancy; compensation; malpractice; negligence claims