A study that evaluated expert reports and rulings in 189 panel proceedings related to 213 hospitals and doctors from nine German federal states from 2000 to 2007 confirmed that incorrectly treated fractures in children are one of the medical errors most commonly confirmed in the arbitration process.

The study, which covered 283 complaints, was carried out by Heinrich Vinz and Johann Neu of the Arbitration Board of the North German Medical Associations, Hanover, and published in Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106(30): 491-8).

The researchers also examined which type of specialists were involved in the procedures, the sites of fracture of each child, together with possible treatment errors and their outcomes.

The North German Arbitration Board dealt with 24 approximately cases of childhood fractures per year – the most common type of complaint related to errors in children, followed by appendicitis (about 10 cases per year).

Bone fracture treatment errors in children were confirmed in 64% of cases – twice the average arbitration figure found in other areas of treatment.

The essential errors were:

  • Inaccurate diagnostic evaluation
  • Not interpreting X-rays correctly
  • Conservative or operative treatment that was inappropriate to the fracture pattern
  • Inadequate control of the fracture

The area of the elbow had the highest rate of errors (77%). In 31% of cases (37 cases) long-term or moderate degree damage resulting from malpractice was confirmed. In 13% of cases (16 cases) severe long-term damage was confirmed.

The malpractice review committees and arbitration boards of the State Medical Associations investigate claims for presumed errors in medical treatment extrajudicially (out of court). The aim of the procedure is to avoid prolonged and costly court cases and this is achieved in over 90% of cases. More than 77,000 patients have contacted the North German Arbitration Board since 1976, when it was founded.

Out of Court Settlement of Malpractice Claims Relating to the Treatment of Fractures in Children
Experience of the Arbitration Board of the North German Medical Associations
Heinrich Vinz, Johann Neu
Link to original article (PDF)

Written by Christian Nordqvist