Intraoperative ureteric injuries and litigation in the NHS

Abstract

Objectives: The objective of this article is to analyse medicolegal claims arising from intraoperative ureteric injuries across all surgical specialties and the consequent financial costs to the National Health Service (NHS) in the United Kingdom. Materials and methods: We conducted a retrospective review of medicolegal claims reported to the NHS Legal Authority between April 2007 and March 2013. Results: A total of 191 claims were reported with 122 claims being resolved at the time of data collation. Of these, 97 were successful with a total of £9.66 million paid by the NHS in indemnity, averaging £99,611 per successful claim. There was an increasing number of claims filed over the study years and a slight decrease in the average pay-out per successful claim. Gynaecology and obstetrics accounted for over two-thirds of successful claims, with the remainder being divided equally among urology and colorectal surgery. However, claims arising from colorectal surgery had higher indemnity pay-outs on average. Conclusion: This is the first study analysing medicolegal claims and cost burden pertaining to ureteric injuries across different specialties. The findings concur with clinical studies which indicate gynaecological procedures and other pelvic (e.g. colorectal) procedures are at increased risk of causing ureteric injury.