Risk factors for injuries associated with damage claims following groin hernia repair.
Surgical repair of groin hernia should be carried out with minimal complication rates, and it is important to have regular quality control and accurate means of assessment. The Swedish healthcare system has a mutual insurance company (LÖF) that receives claims from patients who have suffered healthcare-related damage or malpractice. The Swedish Hernia Register (SHR) currently covers around 98% of all Swedish groin hernia operations. The aim of this study was to analyse damage claims following groin hernia repair surgery and link these with entries in the SHR, in order to identify risk factors and causes of injuries and malpractice associated with hernia repair.



Data on all 48,574 groin hernia operations registered in the SHR between 2008 and 2010 were compared and linked with data on claims made to the Swedish National Patient Injury Insurance (LÖF).



Of the 130 damage claims received by LÖF, 26 dealt with bleeding, 20 with testicular injury and 7 with intestinal lesions. Eighty (62%) of the complications were considered malpractice according to the Swedish Patient Injury Act. Acute and recurrent surgery, sutured repair and general anaesthesia were associated with a significantly increased risk for a damage claim independently the patients were compensated or not. Females filed claims in greater proportion than males. There was no significant difference in background factors between claims accepted by LÖF and compensated and those who were rejected compensation.



Risk factors for filing a damage claim included acute surgery, operation for recurrence, sutured repair and general anaesthesia, whereas local anaesthesia reduced the risk.
Department of Surgical and Perioperative Sciences, Umeå University, Swedish Hernia Register, Östersund, 901 85, Umeå, Sweden. par.nordin@regionjh.se.
P
P
Nordin
Swedish National Patient Insurance Company; LÖF, Stockholm, Sweden.
J
J
Ahlberg
Department of Surgical Sciences, University Hospital, Uppsala and the Swedish Patient Claims Panel, Stockholm, Sweden.
H
H
Johansson
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
H
H
Holmberg
Transplant Institute, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Sweden and the Swedish Patient Claims Panel, Gothenburg, Stockholm, Sweden.
L
L
Hafström
D005260:Female; D006550:Hernia, Femoral / Q000453:epidemiology / Q000601:surgery*; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
Damage claims; Groin hernia repair; Malpractice