Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T19:17:33.704Z Has data issue: false hasContentIssue false
  • English
  • Français

What can be learned from litigation in otology? A review of clinical negligence claims in England 2013–2018

Published online by Cambridge University Press:  16 April 2021

F McClenaghan ,
C Ho ,
J T Machin ,
T W R Briggs ,
A Marshall  and
A V Navaratnam
F McClenaghan*
Affiliation:
The Royal National Throat, Nose and Ear Hospital, London, UK
C Ho
Affiliation:
Getting it Right First Time programme, NHS Improvement, NHS England, UK
J T Machin
Affiliation:
Getting it Right First Time programme, NHS Improvement, NHS England, UK
T W R Briggs
Affiliation:
Getting it Right First Time programme, NHS Improvement, NHS England, UK
A Marshall
Affiliation:
Nottingham University Hospitals NHS Trust, UK
A V Navaratnam
Affiliation:
Getting it Right First Time programme, NHS Improvement, NHS England, UK
*
Author for correspondence: Ms Fiona McClenaghan, The Royal National Throat, Nose and Ear Hospital, 4th Floor West, 250 Euston Road, LondonNW1 2PG, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Litigation in the National Health Service continues to rise with a 9.4 per cent increase in clinical negligence claims from the period 2018 and 2019 to the period 2019 and 2020. The cost of these claims now accounts for 1.8 per cent of the National Health Service 2019 to 2020 budget. This study aimed to identify the characteristics of clinical negligence claims in the subspecialty of otology.

Methods

This study was a retrospective review of all clinical negligence claims in otology in England held by National Health Service Resolution between April 2013 and April 2018.

Results

There were 171 claims in otology, 24 per cent of all otolaryngology claims, with a potential cost of £24.5 million. Over half of these were associated with hearing loss. Stapedectomy was the highest mean cost per claim operation at £769 438. The most common reasons for litigation were failure or delay in treatment (23 per cent), failure or delay in diagnosis (20 per cent), intra-operative complications (15 per cent) and inadequate consent (13 per cent).

Conclusion

There is a risk of high-cost claims in otology, especially with objective injuries such as hearing loss and facial nerve injury.

Keywords

OtolaryngologyJurisprudenceOtologic Surgical Procedures
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 5 , May 2021 , pp. 379 - 384
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Ms F McClenaghan takes responsibility for the integrity of the content of the paper

Presented at the Royal Society of Medicine, 7 February 2020, London, UK.

References

NHS Resolution. NHS Resolution annual report and accounts 2019/2020. In: https://resolution.nhs.uk/2020/07/16/nhs-resolutions-annual-report-and-accounts-2019-20/ [30 August 2020]Google Scholar
National Audit Office. Managing the costs of clinical negligence in trusts. In: https://www.nao.org.uk/wp-content/uploads/2017/09/Managing-the-costs-of-clinical-negligence-in-trusts.pdf [30 August 2020]Google Scholar
NHS Resolution. Our refreshed 2019 to 2022 strategic plan: delivering fair resolution and learning from harm. In: https://resolution.nhs.uk/wp-content/uploads/2020/02/Our-refreshed-2019-2022-strategic-plan.pdf [30 August 2020]Google Scholar
The Partnership for Responsive Policy Analysis and Research (PREPARE). Understanding the drivers of litigation in health services. In: https://www.york.ac.uk/media/healthsciences/images/research/prepare/UnderstandingDriversOfLitigationInHealthServices.pdf [30 August 2020]Google Scholar
Brennan, TA, Sox, CM, Burstin, HR. Relation between negligent adverse events and the outcomes of medical-malpractice litigation. N Engl J Med 1996;26:1963–7CrossRefGoogle Scholar
Patel, A, Harrison, R, Oremule, B. What can we learn from the last 20 years: a review of litigation trends in otolaryngology. Surgeon 2020;18:75–9CrossRefGoogle ScholarPubMed
Zorlu, N, Nash, R, Srinivasan, R. Ten years on from an appraisal of litigation against English Health Trusts in otolaryngology: what have we learnt? Med Leg J 2019;87:88–91CrossRefGoogle ScholarPubMed
Metcalfe, CW, Muzaffar, SJ, Coulson, CJ. Litigation trends and costs in otorhinolaryngology. J Laryngol Otol 2015;129:941–4CrossRefGoogle ScholarPubMed
Cartwright, S, Baer, S, Atrey, A. Appraisal of litigation against English Health Trusts in the treatment of adults with ear, nose & throat pathology: how we do it. Clin Otolaryngol 2010;35:500–3CrossRefGoogle Scholar
Mathew, R, Asimacopoulos, E, Valentine, P. Toward safer practice in otology: a report on 15 years of clinical negligence claims. Laryngoscope 2011;121:2214–9CrossRefGoogle ScholarPubMed
Navaratnam, AV, Hariri, A, Ho, C, Machin, J, Briggs, T, Marshall, A. Otorhinolaryngology litigation in England: 727 clinical negligence cases against the NHS. Clin Otolaryngol 2021;46;9–15CrossRefGoogle Scholar
Ruhl, DS, Hong, SS, Littlefield, PD. Lessons learned in otologic surgery: 30 years of malpractice cases in the United States. Otol Neurotol 2013;34:1173–9CrossRefGoogle ScholarPubMed
Blake, DM, Svider, PF, Carniol, ET, Mauro, AC, Eloy, JA, Jyung, RW. Malpractice in otology. Otolaryngol Head Neck Surg 2013;149:554–61CrossRefGoogle ScholarPubMed
Prabhu, AV, Quang, TS, Funahashi, R et al. A National WestlawNext database analysis of malpractice litigation in radiation oncology. Fed Pract 2018;35(suppl 1):S44–S52Google ScholarPubMed
Bhutta, MF, Williamson, IG, Sudhoff, HH. Cholesteatoma. BMJ 2011;342:d1088CrossRefGoogle ScholarPubMed
Ferguson, GR, Bacila, IA, Swamy, M. Does current provision of undergraduate education prepare UK medical students in ENT? A systematic literature review. BMJ Open 2016;6:e010054CrossRefGoogle ScholarPubMed
NHS England Elective Care Transformation Programme. Transforming elective care services. In: https://www.england.nhs.uk/wp-content/uploads/2019/04/ear-nose-throat-elective-care-handbook.pdf [30 August 2020]Google Scholar
Mbao, MN, Eikelboom, RH, Atlas, MD, Gallop, MA. Evaluation of video-otoscopes suitable for tele-otology. Telemed J e-Health 2020;9:325–30CrossRefGoogle Scholar
Chan, SW, Tulloch, E, Cooper, ES, Smith, A, Wojcik, W, Norman, JE. Montgomery and informed consent: where are we now? BMJ 2017;357:j2224CrossRefGoogle ScholarPubMed
The Royal College of Surgeons. Good Surgical Practice 2014. In: https://www.rcseng.ac.uk/standards-and-research/gsp/ [30 August 2020]Google Scholar
Mathew, RG, Ferguson, V, Hingorani, M. Clinical negligence in ophthalmology: fifteen years of national health service litigation authority data. Ophthalmology 2013;120:859–64CrossRefGoogle ScholarPubMed
Reilly, BK, Horn, GM, Sewell, RK. Hearing loss resulting in malpractice litigation: what physicians need to know. Laryngoscope 2013;123:112–7CrossRefGoogle ScholarPubMed
Ruhl, DS, Cable, BB, Martell, DW. Medication associated with hearing loss: 25 years of medical malpractice cases in the United States. Otolaryngol neck Surg 2014;151:431–7CrossRefGoogle ScholarPubMed
House, JW. Iatrogenic facial paralysis. Ear Nose Throat J 1996;75:720–23CrossRefGoogle ScholarPubMed
Gidley, PW, Maw, J, Gantz, B, Kaylie, D, Lambert, P, Malekzadeh, S et al. Contemporary opinions on intraoperative facial nerve monitoring. OTO Open 2018;2:2473974X18791803CrossRefGoogle ScholarPubMed
Lydiatt, DD. Medical malpractice and facial nerve paralysis. Arch Otolaryngol Head Neck Surg 2003;129:50–3CrossRefGoogle ScholarPubMed
NHS Digital. Hospital Admitted Patient Care Activity 2018-19. In: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2018-19 [30 August 2020]Google Scholar