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英格兰的医院牙科诉讼:2015 - 2020年针对国民保健服务体系的临床疏忽索赔

Hospital dentistry litigation in England: clinical negligence claims against the NHS 2015-2020.

作者信息

Blanchard Jessica R, Koshal Sonita, Navaratnam Annakan, Machin John T, Briggs Tim W R, Jones Elizabeth

机构信息

Department of Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, 47-49 Huntley Street, London, WC1E 6DG, UK.

Royal National ENT and Eastman Dental Hospitals, UCLH, 47-49 Huntley Street, London, WC1E 6DG, UK; Getting it Right First Time Programme, NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK.

出版信息

Br Dent J. 2022 Sep 6. doi: 10.1038/s41415-022-4965-4.

Abstract

Introduction Litigation against the NHS in England is rising. The aim of this study was to determine the incidence and characteristics of hospital dentistry clinical negligence claims in England.Methods A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to hospital dentistry between April 2015 and April 2020. Analysis was performed using the information for cause, patient injury and claim cost.Results A total of 492 claims were identified, with an estimated potential cost of £14 million. The most frequent causes for clinical negligence claims included failure/delay in treatment (n = 175; £3.9 million), inappropriate treatment (n = 56; £1.8 million) and failure to warn/obtain informed consent (n = 37; £1.5 million). Wrong site surgery was cited in 33 claims. The most frequent injury reported was dental damage (n = 197; £4.3 million), unnecessary pain (n = 125; £2.3 million) and nerve damage (n = 52; £2.4 million).Conclusion Clinical negligence claims in hospital dentistry are related to several different aspects of patient management and are not limited to treatment complications alone. Human ergonomics and patient perception of dentistry cannot be controlled but a focus on patient safety measures and effective communication can serve as tools to combat these factors.

摘要

引言 针对英国国民医疗服务体系(NHS)的诉讼正在增加。本研究的目的是确定英格兰医院牙科临床疏忽索赔的发生率和特征。

方法 对NHS Resolution在2015年4月至2020年4月期间持有的英格兰所有与医院牙科相关的临床疏忽索赔进行回顾性研究。使用有关原因、患者伤害和索赔成本的信息进行分析。

结果 共识别出492项索赔,估计潜在成本为1400万英镑。临床疏忽索赔最常见的原因包括治疗失败/延迟(n = 175;390万英镑)、不适当的治疗(n = 56;180万英镑)以及未进行警告/未获得知情同意(n = 37;150万英镑)。33项索赔中提到了手术部位错误。报告的最常见伤害是牙齿损伤(n = 197;430万英镑)、不必要的疼痛(n = 125;230万英镑)和神经损伤(n = 52;240万英镑)。

结论 医院牙科的临床疏忽索赔与患者管理的几个不同方面有关,并不局限于治疗并发症。人体工程学和患者对牙科的认知无法控制,但关注患者安全措施和有效沟通可以作为应对这些因素的工具。

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