Claims Trends in Obstetrics and Gynaecology

Presentation by John MeadTechnical Claims Director

NHS Litigation Authority

26th April 2007

Clinical Negligence-Numbers of New Claims Reported

Year ELS/RHA CNST Total

2002/3 471 5,614 6,085

2003/4 336 4,168 4,504

2004/5 303 4,316 4,619

2005/6 161 4,516 4,677

Clinical Negligence-Total Payments per Year

• 2002/3

• 2003/4

• 2004/5• 2005/6

£446.2M

£422.5M

£502.9M

£560.3M

Open Clinical Negligence Claims by Speciality, 31/3/02

25%

12%

8%7%

7%

6%

4%

31%

Obstetrics

OrthopaedicSurgery

General Surgery

Paediatrics

A/E

Gynaecology

General Medicine

Other

Open Clinical Negligence Claims by Speciality, 31/3/07

22%

12%

10%9%9%5%

4%

29%

Obstetrics

OrthopaedicSurgeryA/E

GeneralSurgeryPaediatrics

GeneralMedicineGynaecology

Other

Value of Open Clinical Negligence Claims by Speciality, at 31/3/02

65%11%

3%

3%

1%17% Obstetrics

Paediatrics

Orthopaedics

A/E

Gynaecology

Others

Value of Open Clinical Negligence Claims by Speciality, at 31/3/07

63%10%

4%

4%

1%18% Obstetrics

Paediatrics

A/E

Orthopaedics

Gynaecology

Others

63% = £4,490M

Open Obstetric Claims by Cause, 31/3/07

• Cerebral Palsy• Other Brain Damage

• Erb’s Palsy• Unnecessary Pain• Fatality• Additional Operation(s)• Stillborn• Other

%

42.7

11.6

10.3

4.3

4.1

3.9

2.2

20.9

Total Value of Open Obstetric Claims, 31/3/07

• Cerebral Palsy• Other Brain Damage• Erb’s Palsy• Developmental Delay• Wrongful Birth• Unnecessary Pain• Other

£M

3,296

739

83

77

33

29

233

4,490

Open Obstetric Claims by Cause, 31/3/07

– Failure to respond to abnormal FHR– Failure to recognise complication– Failure to monitor 1st stage of labour– Failure to monitor 2nd stage of labour– Fail/Delayed Treatment– Fail/Delayed Diagnosis– Application of excess force– Other

%20.5

8.48.07.87.76.95.2

35.5

Open Gynaecology Claims by Injury, 31/3/07

– Additional/unnecessary operation– Unnecessary pain– Bowel damage– Bladder damage– Psychiatric/psychological damage– Infertility– Unwanted pregnancy– Cancer– Other

%

24.4

13.9

6.8

4.9

4.7

4.7

4.3

4.0

32.3

Value of Open Gynaecology Claims, 31/3/07

– Brain damage– Additional/unnecessary

operation– Bowel damage– Cancer– Unnecessary pain– Fatality– Wrongful birth– Bladder damage

%16.916.5

10.07.67.14.44.33.9

29.3

Number of Open Gynaecology Claims, by Cause, at 31/3/07

– Intra-operative problems– Failure/delayed diagnosis– Failure/delayed treatment– Failure to recognise complication– Failed sterilisation– Failure to obtain consent– Inappropriate treatment– Others

%

21.6

15.8

13.9

8.1

4.9

4.5

3.0

28.2

Number of New Obstetric & Gynaecological claims received by year

since 2001/02NHSLA Notification Year

Gynaecology Obstetrics

2001/02 610 1,303

2002/03 552 1,148

2003/04 391 907

2004/05 338 827

2005/06 325 801

2006/07 274 705

Total 2,490 5,691

Amounts paid out on Obstetric & Gynaecological Claims by Year

Payment Year Total Paid on Obstetric Claims

£M.

Total Paid on Gynaecology Claims

£M.

2001/02 429 32.9

2002/03 226 12.5

2003/04 163 16.3

2004/05 243 14.9

2005/06 259 13.8

2006/07 272 15.2

Total 1,592 105.6