Harrison William D, Sargazi Nastaran, Yin Qi, Chandrasekar Coonoor R
Liverpool Sarcoma Unit, Royal Liverpool and Broadgreen University Hospitals, United Kingdom.
J Surg Oncol. 2016 Mar;113(4):361-3. doi: 10.1002/jso.24149. Epub 2016 Jan 4.
Poor awareness and knowledge of lumps and bumps can impact on patient outcomes and survival. Late referrals or false reassurance may lead to litigation proceedings. The aim of this study was to identify the litigation cost in sarcoma care and identify areas for improvement.
Orthopaedic litigation between 1995-2010 in England and Wales was obtained from the National Health Service Litigation Authority. Litigation specifically relating to sarcoma in the extremities was identified. Causation, compensation fee, cost of legal defense, and compensation were analyzed.
There were 52 litigation claims. Negligence was proven in 71% (n = 37) of cases. The total cost was £4.4 million (mean of £84,000/case). The mean compensation award was £92,000 (range £650-£978,000) and the mean defense cost was £22,000 (range £0-£102,000). Delayed diagnosis accounted for 89% of cases (n = 48). Negligence following diagnosis was infrequent; inappropriate treatment (n = 2), failure to recognize complications of surgery (n = 2), intra-operative problems (n = 1), failure to refer to a specialist unit after a "whoops procedure" (n = 1).
Once the patient is within the specialist sarcoma unit, there is a very low rate of litigation. Efforts to reduce litigation in sarcoma treatment should focus on early diagnosis and raising awareness of sarcomas. J. Surg. Oncol. 2016;113:361-363. © 2016 Wiley Periodicals, Inc.
对肿块和肿物认识不足及知识欠缺会影响患者的治疗效果和生存率。转诊延迟或错误的安慰可能导致诉讼程序。本研究的目的是确定肉瘤治疗中的诉讼成本，并找出可改进的方面。
从英国国家医疗服务诉讼管理局获取1995年至2010年英格兰和威尔士的骨科诉讼案件。确定与四肢肉瘤具体相关的诉讼。分析因果关系、赔偿费用、法律辩护成本和赔偿情况。
共有52起诉讼索赔。71%（n = 37）的案件被证明存在过失。总成本为440万英镑（平均每案84,000英镑）。平均赔偿金额为92,000英镑（范围为650英镑至978,000英镑），平均辩护成本为22,000英镑（范围为0英镑至102,000英镑）。89%的案件（n = 48）为诊断延迟。诊断后出现过失的情况较少；不当治疗（n = 2）、未认识到手术并发症（n = 2）、术中问题（n = 1）、“失误操作”后未转诊至专科单位（n = 1）。
一旦患者进入肉瘤专科病房，诉讼发生率非常低。减少肉瘤治疗中诉讼的努力应集中在早期诊断和提高对肉瘤的认识上。《外科肿瘤学杂志》2016年；113:361 - 363。© 2016威利期刊公司
