title: Wrist and scaphoid fractures: a 17-year review of NHSLA litigation data.
abstract: Wrist and scaphoid fractures are common injuries seen and treated in everyday orthopaedic practice. The purpose of the study was to assess the trends and reasons for litigation related to wrist and scaphoid fractures within the NHS. Under a freedom of information (FOI) request, data from 1995 to 2012 were provided by the National Health Service Litigation Authority (NHSLA) on all litigation claims made as a result of wrist and scaphoid fractures. A total of 1354 claims relating to the hand and wrist were identified. Wrist and scaphoid fractures accounted for 492 (36.3%) of these claims, and 365 of these claims were settled, representing 74.2% of all wrist and scaphoid fracture claims. Overall, the most common reason for lost claims was due to incorrect, missed or delayed diagnosis (43.5%). Alleged mismanagement (29.5%), poor care (10.1%) and incompetent surgery (8.0%) were other common causes for litigation. This paper augments previous work published in this area and explores litigation trends specific to wrist and scaphoid fractures. We discuss the trends and reasons for litigation in this area, suggesting areas for improvement that may aid health-care professionals who deal with these injuries and potentially help reduce future litigation.
authors.affiliation: Blackpool Victoria Hospital, Whinney Heys Road, Blackpool, Lancashire FY3 8NR, UK. Electronic address: drjow@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Ring
authors.affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan Lane, Wigan WN1 2NN, UK.
authors.forename: C
authors.initials: C
authors.lastname: Talbot
authors.affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan Lane, Wigan WN1 2NN, UK.
authors.forename: J
authors.initials: J
authors.lastname: Price
authors.affiliation: Blackpool Victoria Hospital, Whinney Heys Road, Blackpool, Lancashire FY3 8NR, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dunkow
mesh_terms: D016208:Databases, Factual; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data*; D011885:Radius Fractures / Q000453:epidemiology*; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries; D013222:State Medicine / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends; D006113:United Kingdom / Q000453:epidemiology
keywords: Jurisprudence; Litigation; Medicolegal aspects; Scaphoid bone; Wrist injuries