title: Clinical negligence claims in pediatric surgery in England: pattern and trends.
abstract: OBJECTIVE
  We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery.
  
  
  METHODS
  We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident.
  
  
  RESULTS
  Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims.
authors.affiliation: Department of Paediatric Surgery, UCL Institute of Child Health, London, United Kingdom.
authors.forename: Mandela
authors.initials: M
authors.lastname: Thyoka
mesh_terms: D002648:Child; D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D004739:England; D006801:Humans; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends; D010372:Pediatrics / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends; D013222:State Medicine / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends