Litigation claims following laparoscopic and open inguinal hernia repairs
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ORIGINAL ARTICLE
Litigation claims following laparoscopic and open inguinal hernia repairs R. Varley1,3 · C. Lo1 · B. Alkhaffaf1,2 Received: 9 February 2020 / Accepted: 10 March 2020 © The Author(s) 2020
Abstract Purpose Groin hernia repair is the most frequently performed general surgical operation in the UK. Complications from laparoscopic and open repair are well recognised; however, potential differences are yet to be considered in relation to litigation. Methods Administrative data were obtained and analysed from the NHS Litigation Authority for inguinal hernia-related claims from 1995 to 2016. Claims identified as using an open or laparoscopic approach were compared. Results 880 claims were made, 760 had been settled. 88 laparoscopic and 241 open procedures were identified; 65% laparoscopic and 63% open hernia claims were found to be in favour of the claimant. Payouts totalled to 4.1GBP/4.8EUR/5.3USD million and 9.4GBP/11.0EUR/12.1USD million for laparoscopic (mean 82,824GBP/96,579EUR/106,453USD) and open (mean 66,796GBP/77,892EUR/85,852USD) approaches, respectively. The most common reasons for claim initiation were visceral/vascular injury (54%) in the laparoscopic group, and testicular complications or chronic pain (35%) in the open group. Additional procedures were necessary for 48% and 44% of laparoscopic and open claims, respectively. The highest average payouts were associated with visceral injury, (laparoscopic 116,482GBP/135,820EUR/14 9,715USD; open 199,103GBP/232,246EUR/255,905USD) and vascular injury (laparoscopic 88,624GBP/103,369EU R/113,892USD; open 64,460GBP/75,163EUR/82,870USD). Additional procedures resulted in an average payout of 93,352GBP/108,917EUR/120,008USD (laparoscopic) and 60,408GBP/70,506EUR/77,657USD (open). The most common additional procedures were corrective visceral/vascular repairs, orchidectomy and recurrent hernia repair. Conclusions The rate of litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater. Keywords Hernia · Inguinal hernia · Litigation · Clinical negligence · Laparoscopic hernia
Introduction
This study was presented at the British Hernia Society Meeting in Edinburgh, Nov 2018. * B. Alkhaffaf [email protected] 1
Department of General Surgery, Salford Royal Foundation Trust, Salford, Manchester M6 8HD, UK
2
Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
3
Core Surgical Training Programme, Health Education England, North West (East Sector), Manchester, UK
In 2017/18 the annual ‘cost of harm’ to the National Health Service (NHS) was estimated to be 7-8GBP (8-9EUR/910USD) billion—a figure that has risen yearly along with the frequency of clinical negligence claims [1]. In England, clinical negligence falls under common law jurisdiction— a case-based legal system using precedents set by judges’
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