Malpractice and compensation claims for acute pancreatitis in Norway: characteristics of claimants, claim-rates, outcomes and indemnity compensation.

Abstract

Background: Acute pancreatitis is a potential life-threatening disease derived from different aetiologies. Knowledge about malpractice claims in acute pancreatitis is lacking. The aim of this study was to investigate the occurrence, patterns and outcomes of malpractice claims for management of acute pancreatitis.

Methods: Nationwide observational cohort of compensation claims filed in a single-payer, universal health care system with a national patient injury compensation system and reviewed by hospital specialists, primary care and health law.

Results: Some 40 claims were filed, among 24,715 episodes of acute pancreatitis. On average, 4.4 claims/year were filed, or 1 claim per every 727 episode of acute pancreatitis. Six claims were directed at primary healthcare (general practitioners (n = 4) and the emergency outpatient units (n = 2)), with none approved. Of all claims, 9 (22.5%) were approved, most frequent for biliary aetiology and related to errors or deviation in treatment (8/9). In 3 of the approved claims, death was the outcome of and part of the compensation approval (one under 'rule of exemption' for unexpectedly severe outcome). The adult population-adjusted claims-rate increased from 1.92 to 2.48/million inhabitants during the period. The claim-rate for events of acute pancreatitis increased from 1.48 to 1.58/1000 events of acute pancreatitis. A total indemnity compensation of 3.6 mill NOK (317 000 EUR) was paid.

Conclusion: Malpractice claims in acute pancreatitis are rare considering the number of episodes and variation in aetiology. Over 1 in 5 claims is granted compensation, most often related to treatment of biliary aetiology and for timing or indication of procedures.