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Article ; Online: Hospital dentistry litigation in England: clinical negligence claims against the NHS 2015-2020.

Blanchard, Jessica R / Koshal, Sonita / Navaratnam, Annakan / Machin, John T / Briggs, Tim W R / Jones, Elizabeth

2022

Abstract: Introduction Litigation against the NHS in England is rising. The aim of this study was to determine the incidence and characteristics of hospital dentistry clinical negligence claims in England.Methods A retrospective review was undertaken of all ... ...

Abstract	Introduction Litigation against the NHS in England is rising. The aim of this study was to determine the incidence and characteristics of hospital dentistry clinical negligence claims in England.Methods A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to hospital dentistry between April 2015 and April 2020. Analysis was performed using the information for cause, patient injury and claim cost.Results A total of 492 claims were identified, with an estimated potential cost of £14 million. The most frequent causes for clinical negligence claims included failure/delay in treatment (n = 175; £3.9 million), inappropriate treatment (n = 56; £1.8 million) and failure to warn/obtain informed consent (n = 37; £1.5 million). Wrong site surgery was cited in 33 claims. The most frequent injury reported was dental damage (n = 197; £4.3 million), unnecessary pain (n = 125; £2.3 million) and nerve damage (n = 52; £2.4 million).Conclusion Clinical negligence claims in hospital dentistry are related to several different aspects of patient management and are not limited to treatment complications alone. Human ergonomics and patient perception of dentistry cannot be controlled but a focus on patient safety measures and effective communication can serve as tools to combat these factors.
Language	English
Publishing date	2022-09-06
Publishing country	England
Document type	Journal Article
ZDB-ID	218090-x
ISSN	1476-5373 ; 0007-0610
ISSN (online)	1476-5373
ISSN	0007-0610
DOI	10.1038/s41415-022-4965-4
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Article ; Online: Litigation in thyroid surgery: a pan-specialty review of National Health Service (UK) data.

Arwyn-Jones, James / Ross, Talisa / Navaratnam, Annakan / George, Manish / Machin, John T / Briggs, Tim W R / Tolley, Neil

The Journal of laryngology and otology

2023 Volume 137, Issue 11, Page(s) 1200–1206

Abstract: Objective: Thyroid surgery carries risks that significantly impact patients. This paper describes the landscape of thyroid surgery related litigation claims in the National Health Service from April 2015 to April 2020, to establish learning points in ... ...

Abstract	Objective: Thyroid surgery carries risks that significantly impact patients. This paper describes the landscape of thyroid surgery related litigation claims in the National Health Service from April 2015 to April 2020, to establish learning points in order to improve patient care and minimise litigation risk. Methods: Data were requested from National Health Service Resolution and Hospital Episode Statistics. Claims were classified into operative and non-operative causes. Subspecialty information, incident details and claim costings were analysed. Results: Sixty claims were identified. Thirty-eight claims (63.3 per cent) were closed, with an average total claim cost of £68 816 and average damages paid of £36 349. Claims related to diagnostic issues were most common ( Conclusion: Utilisation of well-established protocols will likely reduce litigation in thyroid surgery, as we move towards a landscape in which the patient journey is thoroughly scrutinised for targeted improvements.
MeSH term(s)	Humans ; State Medicine ; Malpractice ; Thyroid Gland/surgery ; United Kingdom
Language	English
Publishing date	2023-06-07
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	218299-3
ISSN	1748-5460 ; 0022-2151
ISSN (online)	1748-5460
ISSN	0022-2151
DOI	10.1017/S0022215123001044
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Article ; Online: Litigation in pediatric otorhinolaryngology: Lessons in improving patient care.

Burton, Laura Ellen / Navaratnam, Annakan Victor / Magowan, Drew Samuel / Machin, John T / Briggs, Tim W R / Hall, Andrew Christopher

International journal of pediatric otorhinolaryngology

2022 Volume 162, Page(s) 111288

Abstract: Objective(s): Medico-legal claims involving children place a substantial financial burden on health services and have a profound emotional and psychological impact on clinicians. Our objective was to analyze both the common causes and cost of litigation ...

Abstract	Objective(s): Medico-legal claims involving children place a substantial financial burden on health services and have a profound emotional and psychological impact on clinicians. Our objective was to analyze both the common causes and cost of litigation in pediatric otorhinolaryngology. Methods: A retrospective review of all clinical negligence claims within pediatric otolaryngology (0-17 years inclusive) in NHS (National Health Service) England held by the clinical negligence service 'NHS Resolution between' 4/2013 and 4/2020. Results: There were 100 claims in pediatric otorhinolaryngology accounting for an estimated potential total cost of just under £49 million with an average of 14 claims per year. Over half (52%) of claims were related to an operation with cause codes "Operator Error/Intra-Op Problem", "Diathermy Injury" and "Failure to Warn - Consent" most cited. The most common operation cited in a claim was tonsillectomy with an average cost per claim of £47,084. There were 21 claims coded as either "failure to diagnose" or "failure to treat" in relation to cholesteatoma, with an average cost per claim of £61,086. Conclusion: This is the largest study to date analyzing the reasons and potential cost of clinical negligence claims within pediatric otolaryngology. Many learning opportunities exist to reduce patient morbidity, mortality and improve the patient experience through litigation data analysis.
MeSH term(s)	Child ; England ; Humans ; Malpractice ; Otolaryngology ; Patient Care ; State Medicine
Language	English
Publishing date	2022-08-18
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	754501-0
ISSN	1872-8464 ; 0165-5876
ISSN (online)	1872-8464
ISSN	0165-5876
DOI	10.1016/j.ijporl.2022.111288
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Article ; Online: An Analysis of a National Administrative Dataset Demonstrating No Evidence of Increase in Elective Primary Total Hip Arthroplasty Dislocation Rates When Postoperative Hip Precautions are Not Used.

Machin, John T / Gray, William K / Roberts, Ally / Kenworthy, Louise / Manktelow, Andrew R J / Briggs, Timothy W R

The Journal of arthroplasty

2022 Volume 37, Issue 12, Page(s) 2365–2373

Abstract: Background: The purpose of this study is to determine whether there is a higher dislocation rate when postoperative hip precautions are not used for primary total hip arthroplasty (THA).: Methods: A survey was conducted of the hip precautions used by ...

Abstract	Background: The purpose of this study is to determine whether there is a higher dislocation rate when postoperative hip precautions are not used for primary total hip arthroplasty (THA). Methods: A survey was conducted of the hip precautions used by orthopaedic departments in England performing elective primary THA. From the responses to the survey an interrupted time series analysis was performed using the hospital admissions data from the Hospital Episode Statistics (HES) database during the period April 1, 2011 to December 31, 2019 and subsequent dislocations of these prostheses up to June 30, 2020. These were used to determine dislocations within 180 days of primary surgery and emergency readmissions within 30 days of discharge. Results: Records were reviewed from 229,057 patients receiving primary, elective THA across 114 hospitals. In total, 1,807 (0.8%) dislocations were recorded within 180 days of surgery. There were 12,416 (5.4%) emergency readmissions within 30 days of surgery. Within hospitals where hip precautions were stopped, the proportion of patients having a dislocation was 0.8% both before and after stopping precautions, with a significant postintervention trend towards fewer dislocations (P < .001). There was also a significant immediate change in median length of stay from 4 to 3 days (P < .001) but no significant trend in the proportion of emergency readmissions within 30 days. Conclusion: There is no evidence of an increase in early dislocation or 30-day readmission rates after stopping traditional postoperative hip precautions in primary THA. Potential reductions in length of stay will reduce the risks associated with an extended hospital admission, improve service efficiency, and reduce costs.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Hip/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Patient Readmission ; Elective Surgical Procedures ; Patient Discharge ; Joint Dislocations ; Hip Dislocation/epidemiology ; Hip Dislocation/etiology ; Hip Dislocation/prevention & control
Language	English
Publishing date	2022-05-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2022.05.040
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Article: Total ankle replacement : comparison of the outcomes of STAR and Mobility.

Raglan, Martin / Machin, John T / Cro, Suzie / Taylor, Andrew / Dhar, Sunil

Acta orthopaedica Belgica

2020 Volume 86, Issue 1, Page(s) 109–114

Abstract: Total Ankle Replacement is a recognised treatment for end-stage ankle arthritis and an alternative to arthrodesis. This study reviews a single centre series of prospectively collected outcome measures to determine whether the Mobility performs better ... ...

Abstract	Total Ankle Replacement is a recognised treatment for end-stage ankle arthritis and an alternative to arthrodesis. This study reviews a single centre series of prospectively collected outcome measures to determine whether the Mobility performs better than the Scandinavian ankle replacement. The primary outcome measure was the survivorship. Secondary outcome measures consisted of complications and international scoring systems. 147 Scandinavian and 162 Mobility ankle replacements were reviewed at a mean follow up of 12.4 and 7.7 years respectively. The revision rate, which included liner exchange, component exchange or removal of implant was at 7 years 12.3% (18) for Scandinavian and 5.2% (8) for Mobility. The complication rate was 16.5% (22) for Scandinavian compared to 9.9 % (15) for Mobility. The results of our unit compare favourably with previous published studies. In this study the Mobility has been shown to have more favourable results at 7 years compared to the Scandinavian.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Ankle/statistics & numerical data ; Female ; Humans ; Joint Prosthesis/statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Prosthesis Design ; Range of Motion, Articular ; Reoperation/statistics & numerical data ; Treatment Outcome
Language	English
Publishing date	2020-06-17
Publishing country	Belgium
Document type	Comparative Study ; Journal Article
ZDB-ID	210367-9
ISSN	0001-6462 ; 1784-407X
ISSN	0001-6462 ; 1784-407X
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Article ; Online: Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service.

Navaratnam, Annakan Victor / Hariri, Ahmad / Ho, Cherrie / Machin, John T / Briggs, Tim Wr / Marshall, Andrew

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

2020 Volume 46, Issue 1, Page(s) 9–15

Abstract: Introduction: Litigation against the National Health Service (NHS) in England is rising. The aim of this study was to determine the incidence and characteristics of otorhinolaryngology clinical negligence claims in England.: Methods: A retrospective ... ...

Abstract	Introduction: Litigation against the National Health Service (NHS) in England is rising. The aim of this study was to determine the incidence and characteristics of otorhinolaryngology clinical negligence claims in England. Methods: A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to otorhinolaryngology between April 2013 and April 2018. Analysis was performed using information for cause, patient injury and claim cost. Where claim information was adequately detailed, the authors categorised claims by subspecialty, diagnosis and surgery. Results: A total number of 727 claims were identified with an estimated potential cost of £108 million. Out of these, 463 were closed claims. Including open claim reserves, the mean cost of a claim was £148 923. Head and neck surgery was the subspecialty with the highest number of claims (n = 313, 43%) and highest cost (£51.5 million) followed by otology (n = 171, £24.5 million) and rhinology (n = 171, £13.6 million). Over half of claims were associated with an operation (n = 429, 59%) where mastoid surgery (n = 46) and endoscopic sinus surgery (n = 46) were equally associated with the greatest number of claims. The most frequent causes for clinical negligence claims included failure or delay to diagnose (n = 178, 25%), failure or delay to treat (n = 136, 19%), intra-operative complications (n = 130, 18%) and failure of the consent process (n = 107, 15%). Discussion: Clinical negligence claims in otorhinolaryngology are related to several different components of patient management and are not limited to postoperative complications. This study highlights the importance of robust pathways in out-patient diagnostics and the consenting process in order to deliver better patient care and reduce the impact of litigation. Keywords informed consent, malpractice, clinical negligence claims, litigation, otolaryngology.
MeSH term(s)	England ; Humans ; Malpractice/economics ; Malpractice/legislation & jurisprudence ; Malpractice/statistics & numerical data ; Otolaryngology/economics ; Otolaryngology/legislation & jurisprudence ; Otolaryngology/statistics & numerical data ; State Medicine
Language	English
Publishing date	2020-10-02
Publishing country	England
Document type	Editorial
ZDB-ID	2205891-6
ISSN	1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
ISSN (online)	1749-4486
ISSN	1749-4478 ; 0307-7772 ; 1365-2273
DOI	10.1111/coa.13646
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Article ; Online: Correction to: Can spinal surgery in England be saved from litigation: a review of 978 clinical negligence claims against the NHS.

Machin, John T / Hardman, John / Harrison, William / Briggs, Timothy W R / Hutton, Mike

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2018 Volume 28, Issue 1, Page(s) 195

Abstract: Unfortunately, the first author name was incorrectly published in the original publication. The complete correct name is given as below. ...

Abstract	Unfortunately, the first author name was incorrectly published in the original publication. The complete correct name is given as below.
Language	English
Publishing date	2018-10-15
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-018-5794-7
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Article ; Online: Can spinal surgery in England be saved from litigation: a review of 978 clinical negligence claims against the NHS.

Machin, John T / Hardman, John / Harrison, William / Briggs, Timothy W R / Hutton, Mike

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2018 Volume 27, Issue 11, Page(s) 2693–2699

Abstract: Purpose: The aim of this study is to evaluate the true incidence of all clinical negligence claims against spinal surgery performed by orthopaedic spinal surgeons and neurosurgeons in the National Health Service (NHS) in England, including both open and ...

Abstract	Purpose: The aim of this study is to evaluate the true incidence of all clinical negligence claims against spinal surgery performed by orthopaedic spinal surgeons and neurosurgeons in the National Health Service (NHS) in England, including both open and closed claims. Methods: This study was a retrospective review of 978 clinical negligence claims held by NHS Resolution against spinal surgery cases identified from claims against 'Neurosurgery' and 'Orthopaedic Surgery'. This category included all emergency, trauma and elective work and all open and closed cases without exclusion between April 2012 and April 2017. Results: Clinical negligence claims in spinal surgery were estimated to cost £535.5 million over this five-year period. There is a trend of both increasing volume and estimated costs of claims. The most common causes for claims were 'judgement/timing' (512 claims, 52.35%), 'interpretation of results/clinical picture' (255 claims, 26.07%), 'unsatisfactory outcome to surgery' (192 claims, 19.63%), 'fail to warn/informed consent' (80 claims, 8.13%) and 'never events' including 'wrong site surgery' or 'retained instrument post-operation' (26 claims, 2.66%). A sub-analysis of 3 years including 574 claims revealed the most prevalent pathologies were iatrogenic nerve damage (132 claims, 23.00%), cauda equina syndrome (CES) (131 claims, 22.82%), inadequate decompression (91 claims, 15.85%), iatrogenic cord damage (72 claims, 12.54%), and infection (51 claims, 8.89%). Conclusions: The volume and costs of clinical negligence claims is threatening the future of spinal surgery. If spinal surgery is to continue to serve the patients who need it, most thorough investigation, implementation and sharing of lessons learned from litigation claims must be systematically carried out. These slides can be retrieved under Electronic Supplementary Material.
MeSH term(s)	England ; Humans ; Malpractice/economics ; Malpractice/legislation & jurisprudence ; Malpractice/statistics & numerical data ; Orthopedic Procedures/economics ; Orthopedic Procedures/legislation & jurisprudence ; Orthopedic Procedures/statistics & numerical data ; Retrospective Studies ; Spine/surgery ; State Medicine/economics ; State Medicine/legislation & jurisprudence ; State Medicine/statistics & numerical data
Language	English
Publishing date	2018-08-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-018-5739-1
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Article ; Online: Litigation in Ophthalmology against the National Health Service in England.

Kirthi, Varo / Neffendorf, James E / Navaratnam, Annakan V / Machin, John T / Hingorani, Melanie / Briggs, Timothy W R / Davis, Alison / MacEwen, Caroline / Jackson, Timothy L

Ophthalmology

2021 Volume 128, Issue 10, Page(s) 1487–1489

MeSH term(s)	England ; Health Care Costs/legislation & jurisprudence ; Humans ; Malpractice/economics ; Malpractice/legislation & jurisprudence ; Ophthalmology/economics ; Ophthalmology/legislation & jurisprudence ; State Medicine/economics ; State Medicine/legislation & jurisprudence
Language	English
Publishing date	2021-03-23
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	392083-5
ISSN	1549-4713 ; 0161-6420
ISSN (online)	1549-4713
ISSN	0161-6420
DOI	10.1016/j.ophtha.2021.03.028
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Article: Scapular fracture following electronic muscle stimulation.

Modi, Bhavik N / Machin, John T / Tudor, Francois / Peckham, Tim

Journal of surgical case reports

2012 Volume 2012, Issue 1, Page(s) 4

Abstract: We present the case of a transverse fracture of the scapula resulting from the use of electronic muscle stimulation (EMS): highlighting the dangers of these devices that are commonly used for massage and body-building purposes. ...

Abstract	We present the case of a transverse fracture of the scapula resulting from the use of electronic muscle stimulation (EMS): highlighting the dangers of these devices that are commonly used for massage and body-building purposes.
Language	English
Publishing date	2012-01-01
Publishing country	England
Document type	Journal Article
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/2012.1.4
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