Open AccessA nationwide descriptive study of obstetric claims for compensation in Norway
Author(s) -
ANDREASEN STINE,
BACKE BJØRN,
JØRSTAD ROLF GUNNAR,
ØIAN PÅL
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01409.x
Subject(s) - medicine , compensation (psychology) , asphyxia , anal sphincter , health care , norwegian , childbirth , medical emergency , pregnancy , obstetrics , surgery , psychology , linguistics , philosophy , biology , psychoanalysis , economics , genetics , economic growth
Abstract Objective . To describe causes of substandard care in obstetric compensation claims. Design and setting . A nationwide descriptive study in Norway. Population . All obstetric patients who believed themselves inflicted with injuries by the Health Service and applying for compensation. Methods . Data were collected from 871 claims to The Norwegian System of Compensation to Patients during 1994–2008, of which 278 were awarded compensation. Main outcome measures . Type of injury and cause of substandard care. Results . Of 871 cases, 278 (31.9%) resulted in compensation. Of those, asphyxia was the most common type of injury to the child (83.4%). Anal sphincter tear (29.9%) and infection (23.0%) were the most common types of injury to the mother. Human error, both by midwives (37.1% of all cases given compensation) and obstetricians (51.2%), was an important contributing factor in inadequate obstetric care. Neglecting signs of fetal distress (28.1%), more competent health workers not being called when appropriate (26.3%) and inadequate fetal monitoring (17.3%) were often observed. System errors such as time conflicts, neglecting written guidelines and poor organization of the department were infrequent causes of injury (8.3%). Conclusions . Fetal asphyxia is the most common reason for compensation, resulting in large financial expenses to society. Human error contributes to inadequate health care in 92% of obstetric compensation claims, although underlying system errors may also be present.