Ajwani Sanil Harji, Hinduja Kunal
North Manchester General Hospital, Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom.
J Hand Microsurg. 2016 Aug;8(2):96-9. doi: 10.1055/s-0036-1583939. Epub 2016 May 9.
Carpal tunnel surgery represents a significant source of litigation in hand surgery. The aim of this work was to evaluate the burden of successful litigation relating to this type of hand surgery in England. Secondary measures looked at identifying the most common causes of successful legal action.
A retrospective review was conducted on the National Health Service Litigation Authority (NHSLA) database. All successful carpal tunnel surgery-related claims over a 10-year period from 2002 to 2012 were identified. A total of 60 claims were retrieved and analyzed.
The total cost of successful claims to the NHS was £3.9 million. This compromised £2.4 million in damages, with £1.5 million in legal costs (22% in NHS legal costs, the remainder the claimants costs). The mean cost of settling a claim was £65,440 (range £350-£397,134). The commonest cause of the claim was nerve damage. The average damages paid in relation to this injury was £55,460. Additional surgery and poor outcome were the next commonest cause of successful proceedings, with average damages of £28,984.
Legal action in relation to carpal tunnel surgery is a considerable source of cost to hand surgeons and the NHS. The complexity of resolving these cases is reflected in the associated legal costs, which represent a significant proportion of payouts. With improved understanding of factors instigating successful legal proceedings physicians can recognize areas, where practice and training can be improved, and steps can be taken to minimize injury.
腕管手术是手部手术中引发诉讼的一个重要原因。本研究旨在评估在英国，这类手部手术成功诉讼所带来的负担。次要目标是找出成功法律诉讼的最常见原因。
对英国国家医疗服务诉讼管理局（NHSLA）数据库进行回顾性研究。确定了2002年至2012年这10年间所有与腕管手术相关的成功索赔案例。共检索并分析了60起索赔案例。
成功索赔给英国国家医疗服务体系（NHS）带来的总成本为390万英镑。其中损害赔偿金为240万英镑，法律费用为150万英镑（NHS法律费用占22%，其余为索赔人费用）。解决一项索赔的平均成本为65,440英镑（范围为350英镑至397,134英镑）。索赔的最常见原因是神经损伤。针对该损伤支付的平均损害赔偿金为55,460英镑。再次手术和效果不佳是成功诉讼的第二常见原因，平均损害赔偿金为28,984英镑。
与腕管手术相关的法律诉讼是手部外科医生和NHS成本的一个重要来源。解决这些案件的复杂性体现在相关的法律费用上，法律费用在赔付中占很大比例。随着对引发成功法律诉讼因素的理解加深，医生能够认识到可以改进实践和培训的领域，并采取措施将伤害降至最低。
