Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jan 9, 2022; 11(1): 40-47
Published online Jan 9, 2022. doi: 10.5492/wjccm.v11.i1.40
Medico-legal risks associated to hand and wrist trauma
Dionysia Vasdeki, Sokratis E Varitimidis, Charalambos Chryssanthakis, Nikolaos Stefanou, Zoe H Dailiana
Dionysia Vasdeki, Nikolaos Stefanou, Zoe H Dailiana, Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, Larissa 41500, Greece
Sokratis E Varitimidis, Department of Orthopaedics, University of Thessalia, Larissa 41110, Greece
Charalambos Chryssanthakis, Department of Administrative Science and Public Administration, National and Kapodistrian University of Athens, Athens 10678, Greece
Zoe H Dailiana, Department of Hand, Upper Extremity and Microsurgery, Iaso Thessalias, Nikaia, Larissa 41500, Greece
Author contributions: Dailiana ZH and Chryssanthakis C designed the study; Vasdeki D and Stefanou N performed the research and analyzed the data; Vasdeki D wrote the manuscript; Dailiana ZH, Chryssanthakis C and Varitimidis SE made critical revisions related to the content of the manuscript; Dailiana ZH performed the language editing of the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study has been approved by the Ethics Committee of the Faculty of Medicine, School of Health Sciences, University of Thessaly, No. 16/12.02.2019.
Conflict-of-interest statement: None declared. None of the authors has received fees for serving as a speaker for any organization. None of the authors has received research funding. None of the authors is an employee of any organization. None of the authors owns stocks and/or shares. None of the authors owns any patent.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zoe H Dailiana, MD, PhD, Professor, Surgeon, Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, 3 Panepistimiou Street, Biopolis, Larissa 41500, Greece. dailiana@med.uth.gr
Received: April 25, 2021
Peer-review started: April 25, 2021
First decision: June 17, 2021
Revised: June 16, 2021
Accepted: November 21, 2021
Article in press: November 21, 2021
Published online: January 9, 2022
Processing time: 254 Days and 13.7 Hours
ARTICLE HIGHLIGHTS
Research background

Medical negligence claims have presented an upward trend over the last decades worldwide, with hand and wrist liability representing a significant burden of orthopedic surgery lawsuits. Hand and wrist injuries are common, affecting mainly young and economically productive people. However, even small injuries may lead to long-term disability if treated inadequately, with affected people becoming unable to work, socialize and perform routine daily activities.

Research motivation

Literature addressing the issue of malpractice in hand and wrist surgery has been scarce, with most studies being performed in Europe and the United States. However, there are no studies related to liability in hand and wrist trauma and surgery in Greece.

Research objectives

The purpose of this study was to identify medical malpractice claims in hand and wrist surgery in Greece, to define the reasons for filing a claim and to define the reasons of successful litigations. Additionally, the results of the study were compared with the international malpractice data.

Research methods

This is a retrospective study of all medical malpractice claims for hand and upper extremity surgery that went to a trial attributed to all surgical specialties in Greece over a 20-year period. Claims were further analyzed to identify claims related to hand and wrist trauma and surgery.

Research results

We presented six medical malpractice cases related to hand and wrist trauma that ended in a trial. Missed diagnosis and subsequent failure of initial management of the injury was the main reason for filing a claim. In half of the cases mismanagement resulted in complete or partial loss of a finger. Two cases are still open, two cases were closed in favor of the defendant, and two cases were closed in favor of the plaintiff with a mean compensation of €2000.

Research conclusions

This is the first report of medical negligence claims related to hand and wrist trauma in Greece. A missed diagnosis of hand and wrist injury can result in long-term disability for a patient and has been the main reason for a malpractice claim. In the present study, missed diagnosis resulted in partial or complete loss of a finger in half of the cases.

Research perspectives

Better understanding of the factors that lead to successful claims can result in the improvement of services to hand trauma patients and will help surgeons improve their practice to minimize legal implications and litigation.