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Lessons from rhinology and facial plastic surgery clinical negligence claims in England 2013–2018

Published online by Cambridge University Press:  03 December 2021

A V Navaratnam*
Affiliation:
Getting it Right First Time programme, NHS England and NHS Improvement, London, UK Royal National ENT Hospital, University College London NHS Trust, UK
A L Pendolino
Affiliation:
UCL Ear Institute, London, UK
A Kaura
Affiliation:
UCL Ear Institute, London, UK
J Nijim
Affiliation:
UCL Medical School, London, UK
J T Machin
Affiliation:
Getting it Right First Time programme, NHS England and NHS Improvement, London, UK
T W R Briggs
Affiliation:
Getting it Right First Time programme, NHS England and NHS Improvement, London, UK
A Marshall
Affiliation:
Nottingham University Hospitals NHS Trust, UK
P S Randhawa
Affiliation:
Royal National ENT Hospital, University College London NHS Trust, UK
P J Andrews
Affiliation:
Royal National ENT Hospital, University College London NHS Trust, UK
*
Author for correspondence: Dr A V Navaratnam, Royal National ENT Hospital, 47-49 Huntley Street, LondonWC1 EGE, UK E-mail: [email protected]

Abstract

Objective

This study reviewed all rhinology clinical negligence claims in the National Health Service in England between 2013 and 2018.

Method

All clinical negligence claims held by National Health Service Resolution relating to rhinology in England between 1 April 2013 and 1 April 2018 were reviewed.

Results

There were 171 rhinology related claims with a total estimated potential cost of £13.6 million. There were 119 closed claims (70 per cent) with a total cost of £2.3 million, of which 55 claims resulted in payment of damages. Over three quarters of all rhinology claims were associated with surgery (n = 132). Claims associated with endoscopic sinus surgery had the highest mean cost per claim (£172 978). Unnecessary pain (33.9 per cent) and unnecessary operation (28.1 per cent) were the most commonly cited patient injuries.

Conclusion

Patient education and consent have been highlighted as key areas for improvement from this review of rhinology related clinical negligence claims. A shift in clinical practice towards shared decision making could reduce litigation in rhinology.

Type
Main Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr A V Navaratnam takes responsibility for the integrity of the content of the paper

Presented as an oral presentation at the European Rhinologic Society, 26 to 30 September 2021, Thessaloniki, Greece.

References

National Audit Office. Managing the costs of clinical negligence in trusts. In: https://www.nao.org.uk/report/managing-the-costs-of-clinical-negligence-in-trusts/ [1 August 2021]Google Scholar
NHS Resolution. Our refreshed 2019 to 2022 strategic plan: delivering fair resolution and learning from harm. The Early Notification scheme progress report: collaboration and improved experience for families (resolution.nhs.uk). In: https://resolution.nhs.uk/wp-content/uploads/2020/02/Our-refreshed-2019-2022-strategic-plan.pdf [1 August 2021]Google Scholar
Metcalfe, CW, Muzaffar, SJ, Coulson, CJ. Litigation trends and costs in otorhinolaryngology. J Laryngol Otol 2015;129:941–4CrossRefGoogle ScholarPubMed
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 Scholar
Breen, CT, Mehra, S. An analysis of otolaryngology medical malpractice payments from the national practitioner data bank. Otolaryngol Head Neck Surg 202;164:589–94Google Scholar
Svider, PF, Husain, Q, Kovalerchik, O, Mauro, AC, Setzen, M, Baredes, S et al. Determining legal responsibility in otolaryngology: a review of 44 trials since 2008. Am J Otolaryngol Head Neck Med Surg 2013;34:699705Google ScholarPubMed
Hong, SS, Yheulon, CG, Wirtz, ED, Sniezek, JC. Otolaryngology and medical malpractice: a review of the past decade, 2001-2011. Laryngoscope 2014;124:896901CrossRefGoogle ScholarPubMed
Ceremsak, J, Miller, LE, Gomez, ED. A review of otolaryngology malpractice cases with associated court proceedings from 2010 to 2019. Laryngoscope 2021;13:E1081–5Google Scholar
Stankiewicz, JA, Lal, D, Connor, M, Welch, K. Complications in endoscopic sinus surgery for chronic rhinosinusitis: a 25-year experience. Laryngoscope 2011;121:2684–701CrossRefGoogle ScholarPubMed
Hopkins, C, Browne, JP, Slack, R, Lund, VJ, Topham, J, Reeves, BC et al. Complications of surgery for nasal polyposis and chronic rhinosinusitis: the results of a national audit in England and Wales. Laryngoscope 2006;116:1494–9CrossRefGoogle Scholar
Svider, PF, Keeley, BR, Zumba, O, Mauro, AC, Setzen, M, Eloy, JA. From the operating room to the courtroom: a comprehensive characterization of litigation related to facial plastic surgery procedures. Laryngoscope 2013;123:1849–53CrossRefGoogle Scholar
UKRI Medical Research Council. Is my study research? In: hra-decisiontools.org.uk [2 January 2021]Google Scholar
Geyton, T, Odutoye, T, Mathew, R. A report on 15 years of clinical negligence claims in rhinology. Am J Rhinol Allergy 2014;28:e219–23CrossRefGoogle ScholarPubMed
Harris, AS, Edwards, SJ, Pope, L. Litigation in English rhinology. J Laryngol Otol 2015;129:244–9CrossRefGoogle ScholarPubMed
Dawson, DE, Kraus, EM. Medical malpractice and rhinology. Am J Rhinol 2007;21:584–90CrossRefGoogle ScholarPubMed
Vennik, J, Eyles, C, Thomas, M, Hopkins, C, Little, P, Blackshaw, H et al. Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care. BMJ Open 2019;9:e022644CrossRefGoogle ScholarPubMed
Wever, CCC, Wever, AMEA, Constantian, M. Psychiatric disorders in facial plastic surgery. Facial Plast Surg Clin North Am 2020;28:451–60CrossRefGoogle ScholarPubMed
Veer, V, Jackson, L, Kara, N, Hawthorne, M. Pre-operative considerations in aesthetic facial surgery. J Laryngol Otol 2014;128:22–8CrossRefGoogle ScholarPubMed
Wolf, JS, Chiu, AG, Palmer, JN, O'Malley, BW, Schofield, K, Taylor, RJ. Informed consent in endoscopic sinus surgery: the patient perspective. Laryngoscope 2005;115:492–4CrossRefGoogle ScholarPubMed
ENT UK. Patient leaflets. In: https://www.entuk.org/patient-information-leaflets [1 August 2021]Google Scholar
Henney, S, Irving, R. Prospective, randomised, controlled trial comparing delivery of patient information for functional endoscopic sinus surgery via website versus printed leaflet. J Laryngol Otol 2014;128:249–54CrossRefGoogle ScholarPubMed
Siu, JM, Rotenberg, BW, Franklin, JH, Sowerby, LJ. Multimedia in the informed consent process for endoscopic sinus surgery: a randomized control trial. Laryngoscope 2016;126:1273–8CrossRefGoogle ScholarPubMed
Rudmik, L, Soler, ZM, Mace, JC, Deconde, AS, Schlosser, RJ, Smith, TL. Using preoperative SNOT-22 score to inform patient decision for endoscopic sinus surgery. Laryngoscope 2015;125:1517–22CrossRefGoogle ScholarPubMed
Boss, EF, Mehta, N, Nagarajan, N, Links, A, Benke, JR, Berger, Z et al. Shared decision making and choice for elective surgical care: a systematic review. Otolaryngol Head Neck Surg 2016;154:405–20CrossRefGoogle ScholarPubMed
Andrews, PJ, Choudhury, N, Takhar, A, Poirrier, AL, Jacques, T, Randhawa, PS. The need for an objective measure in septorhinoplasty surgery: are we any closer to finding an answer? Clin Otolaryngol 2015;40:698703CrossRefGoogle ScholarPubMed
Tolisano, AM, Justin, GA, Ruhl, DS, Cable, BB. Rhinology and medical malpractice: an update of the medicolegal landscape of the last ten years. Laryngoscope 2016;126:1419CrossRefGoogle ScholarPubMed
Brennan, TA, Sox, CM, Burstin, HR. Relation between negligent adverse events and the outcomes of medical-malpractice litigation. N Engl J Med 1996;335:1963–7CrossRefGoogle ScholarPubMed
Svider, PF, Kovalerchik, O, Mauro, AC, Baredes, S, Eloy, JA. Legal liability in iatrogenic orbital injury. Laryngoscope 2013;123:2099–103CrossRefGoogle ScholarPubMed
Kovalerchik, O, Mady, LJ, Svider, PF, Mauro, AC, Baredes, S, Liu, JK et al. Physician accountability in iatrogenic cerebrospinal fluid leak litigation. Int Forum Allergy Rhinol 2013;3:722–5CrossRefGoogle ScholarPubMed
Ahn, SH, Lee, EJ, Kim, JW, Baek, KH, Cho, H-J, Yoon, J-H et al. Better surgical outcome by image-guided navigation system in endoscopic removal of sinonasal inverted papilloma. J Craniomaxillofac Surg 2018;46:937–41CrossRefGoogle ScholarPubMed
Dalgorf, DM, Sacks, R, Wormald, PJ, Naidoo, Y, Panizza, B, Uren, B et al. Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2013;149;1729CrossRefGoogle ScholarPubMed
Vicaut, E, Bertrand, B, Betton, J-L, Bizon, A, Briche, D, Castillo, L et al. Use of a navigation system in endonasal surgery: impact on surgical strategy and surgeon satisfaction. A prospective multicenter study. Eur Ann Otorhinolaryngol Head Neck Dis 2019;136:461–4CrossRefGoogle ScholarPubMed
Ramakrishnan, VR, Kingdom, TT. Does image-guided surgery reduce complications? Otolaryngol Clin North Am 2015;48:851–9CrossRefGoogle ScholarPubMed
Eloy, JA, Svider, PF, D'Aguillo, CM, Baredes, S, Setzen, M, Folbe, AJ. Image-guidance in endoscopic sinus surgery: is it associated with decreased medicolegal liability? Int Forum Allergy Rhinol 2013;3:980–5CrossRefGoogle ScholarPubMed
Re, M, Magliulo, G, Romeo, R, Gioacchini, FM, Pasquini, E. Risks and medico-legal aspects of endoscopic sinus surgery: a review. Eur Arch Otorhinolaryngol 2014;271:2103–17CrossRefGoogle ScholarPubMed
Sweis, IE, Spitz, J, Barry, DR, Cohen, M. A review of body dysmorphic disorder in aesthetic surgery patients and the legal implications. Aesthetic Plast Surg 2017;41:949–54CrossRefGoogle ScholarPubMed
Joseph, J, Randhawa, P, Hannan, SA, Long, J, Goh, S, O'Shea, N et al. Body dysmorphic disorder in patients undergoing septorhinoplasty surgery: should we be performing routine screening? Clin Otolaryngol 2017;42:508–13CrossRefGoogle ScholarPubMed