A Review Of Negligence In Orthopaedic Surgery

Main Category: Bones / Orthopedics
Article Date: 05 Feb 2009 - 4:00 PDT

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The rise of medical negligence claims brought against the NHS saw payments rise to £424 million in 2006 to 2007, an increase of £40 million on the previous year. An article published today in The Journal of Bone and Joint Surgery, British Volume charts this trend in orthopaedics to see if any lessons can be learned from the implementation of expert witness reports.

The authors review 130 medical negligence cases relating to orthopaedic surgery and conclude that while the full impact of Woolf's Civil Procedure Rules have yet to be determined the fact that 'over half of the cases were abandoned by the claimant as a consequence of the expert's report' indicates they are working.

None of the cases ended in court, the 44 cases where liability was admitted were settled prior to this being necessary. While in a sense a settlement represents a loss, the expert's reports were 'extremely helpful in limiting the size of this' in these cases. The settlements ranged from £4,500 to £2.7 million with the median settlement being £45,000. Most of the settled cases were related to delays in treatment or diagnosis or substandard surgical technique.

However, one of the cases threw into relief important issues regarding surgical practice in orthopaedics. In the event of complications 'a lack of clear documentation in the operation note that reasonable precautions were taken during surgery' was critical in determining liability. Therefore, the authors recommend that a record be kept 'of the identification and protection of specific nerves' in order to prevent litigation from complications surrounding nerve damage.

In addition, the time taken from a negligence claim being submitted and resolution or withdrawal is a cause for concern. Every delay adds to costs for both parties and in 2006 to 2007 legal costs amounted to almost £100 million, nearly one third of the value of claims. Therefore, 'despite the success of the Woolf reforms in bringing the sides together, further progress needs to be made to accelerate the process of conciliation, with early meetings and an attempt to resolve claims at an early stage'.

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The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868

JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott

The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches

The Journal of Bone and Joint Surgery - British Volume

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