NHSLA litigation in hip fractures: Lessons learnt from NHSLA data |
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| Affiliation: | 1. Department of Orthopaedics, Cedars-Sinai Spine Center, 444 S. San Vicente Blvd., Suite 800, Los Angeles, CA 90048, USA;2. Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, USA;3. Boston University School of Medicine, 72 E Concord St., Boston, MA 02118, USA;4. Cedars-Sinai Spine Center, 444 S. San Vicente Blvd., Suite 800, Los Angeles, CA 90048, USA;5. Department of Neurosurgery, Cedars-Sinai Spine Center, 444 S. San Vicente Blvd., Suite 800, Los Angeles, CA 90048, USA;1. Swedish Medical Centre, Trauma Research Department, Englewood, CO, USA;2. St. Anthony Hospital, Trauma Research Department, Lakewood, CO, USA;3. The Medical Centre of Plano, Plano, TX, USA;4. Penrose Hospital, Colorado Springs, CO, USA;5. Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA;1. Department of Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada;2. Solidage-McGill University/Université de Montréal research group on frailty and aging, Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research Studies, Jewish General Hospital, McGill University, Montreal, Quebec, Canada;3. Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada |
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| Abstract: | Hip fractures are a major cause of trauma related death, usually occurring in vulnerable elderly patients. There are an estimated 70,000 hip fractures in the UK per year with numbers set to rise. The estimated annual cost to the healthcare economy is in the region of £2 billion. A 17-year review examining litigation related to hip fractures was undertaken.Under a freedom of information request, data was obtained relating to all orthopaedic claims made to the NHS Litigation Authority (NHSLA) between 1995 and 2012. Data was filtered to identify cases involving hip fractures examining litigation trends related to this specific area.10263 NHSLA orthopaedic cases were identified, of which 13.3% (n = 1364) cases related to the hip and femur. Hip fractures made up 16.7% (n = 229). The total cost of hip fracture litigation was over £7 million with an average cost per case of £32,700. The commonest reasons for litigation were diagnostic errors (30.6%), issues with care (24.9%) alleged incompetent surgery (15.7%) and development of pressure sores (5.7%).This study highlights the main causes of litigation in patients sustaining hip fractures, with diagnosis in the emergency department and ward presenting a significant problem. In addition, the data identifies a range of care related issues, as well as several surgical factors and highlights the importance of pressure area care. We discuss these and make suggestions on how to improve practice in this area with the aim of improving patient care and reducing litigation. |
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| Keywords: | Hip fractures Femoral neck fractures Legislation & jurisprudence Legal aspects Litigation Medicolegal aspect |
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