A decade of litigation regarding surgical informed consent in the Netherlands

Patient Educ Couns. 2019 Feb;102(2):340-345. doi: 10.1016/j.pec.2018.08.031. Epub 2018 Aug 29.

Abstract

Objective: An inadequate surgical informed consent process (SIC) may result in a medical malpractice claim or medical disciplinary board (MDB) complaint. Aim of this study was to analyse characteristics of a decade of malpractice claims and MDB decisions regarding SIC in the Netherlands.

Methods: A retrospective analysis of malpractice claims and MDB decisions concerning SIC disputes in four major surgical specialties was conducted based on company data from the largest medical malpractice insurance company and two public available online MDB databases.

Results: A total of 11376 malpractice claims and 661 MDB complaints were filed between 2004-2013 and 676(6%) of these claims and 69(10%) of these complaints involved an alleged deficient SIC process. A random sample of 245(37%) claims and all MDB decisions were analysed. Reasons for filing a claim or complaint were insufficient counselling or recording of SIC elements. In 20% of lawsuits and 25% of claims the case resulted in favour of the complainant.

Conclusion: A substantial portion of malpractice claims and MDB decisions is related to a deficient SIC process.

Practice implications: Focusing on crucial SIC elements for patients may improve satisfaction and expectations and result in a lower risk for malpractice claims and MDB complaints.

Keywords: Informed consent; Litigation; Malpractice claims; Medical disciplinary board; Surgical procedure.

MeSH terms

  • Compensation and Redress* / legislation & jurisprudence
  • Female
  • Gynecologic Surgical Procedures / statistics & numerical data
  • Humans
  • Informed Consent / legislation & jurisprudence*
  • Informed Consent / statistics & numerical data
  • Insurance Claim Review / statistics & numerical data*
  • Male
  • Malpractice / legislation & jurisprudence*
  • Malpractice / statistics & numerical data
  • Netherlands
  • Orthopedic Procedures / statistics & numerical data
  • Plastic Surgery Procedures / statistics & numerical data
  • Retrospective Studies
  • Surgeons
  • Surgery, Plastic / statistics & numerical data
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / statistics & numerical data*