Patient injury claims involving fractures of the distal radius : 208 compensated claims from the Finnish Patient Insurance Center

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http://hdl.handle.net/10138/234662

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Sandelin , H , Waris , E , Hirvensalo , E , Vasenius , J , Huhtala , H , Raatikainen , T & Helkamaa , T 2018 , ' Patient injury claims involving fractures of the distal radius : 208 compensated claims from the Finnish Patient Insurance Center ' , Acta Orthopaedica , vol. 89 , no. 2 , pp. 240-245 . https://doi.org/10.1080/17453674.2018.1427966

Title: Patient injury claims involving fractures of the distal radius : 208 compensated claims from the Finnish Patient Insurance Center
Author: Sandelin, Henrik; Waris, Eero; Hirvensalo, Eero; Vasenius, Jarkko; Huhtala, Heini; Raatikainen, Timo; Helkamaa, Teemu
Contributor: University of Helsinki, Faculty of Medicine
University of Helsinki, I kirurgian klinikka (Töölö)
University of Helsinki, I kirurgian klinikka (Töölö)
University of Helsinki, Department of Surgery
University of Helsinki, Clinicum
Date: 2018
Language: eng
Number of pages: 6
Belongs to series: Acta Orthopaedica
ISSN: 1745-3674
URI: http://hdl.handle.net/10138/234662
Abstract: Background and purpose Optimal treatment for distal radius fractures remains controversial, with a significant number of fractures resulting in complications and long-term morbidity. We investigated patient injury claims related to distal radius fractures to detect the critical steps in the treatment leading to avoidable adverse eventsPatients and methods We analyzed all compensated patient injury claims in Finland between 2007 and 2011. Claims were collected from the Patient Insurance Center's (PIC) nationwide claim register. Patients of all ages were included. Each claim decision, original patient records, and radiographs related to treatment were reviewed.Results During the study period, the PIC received 584 claims regarding distal radius fractures, of which 208 (36%) were compensated. Pain and impaired wrist function were the most common subjective reasons to file claims among compensated patients. In 66/208 patients, more than 1 adverse event leading to patient injury was detected. The detected adverse events could be divided into 3 main groups: diagnostic errors (36%, n = 103), decision/planning errors (30%, n = 87), and insufficient technical execution (32%, n = 91). Issues related to malalignment were the main concerns in each group. Diagnostic errors were often related to incorrect assessment of the fracture (re)displacement (75%, n = 78). All of the decision-making errors concerned physicians' decisions to accept unsatisfactory fracture alignment. The most common technical error was insufficient reduction (29%, n = 26).Interpretation We identified avoidable adverse events behind patient injuries related to distal radius fracture treatment. This study will help physicians to recognize the critical steps in the treatment of this common fracture and enhance patient safety.
Subject: MALPRACTICE CLAIMS
NONOPERATIVE TREATMENT
DIAGNOSTIC ERRORS
UNITED-STATES
EPIDEMIOLOGY
HAND
COMPLICATIONS
EMERGENCY
SURGERY
FINLAND
3126 Surgery, anesthesiology, intensive care, radiology
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