• Wouter J Dronkers, Dennis R Buis, Quirine J M A Amelink, Gert-Joan Bouma, Wilco C Peul, W Peter Vandertop, BroekmanMarike L DMLDDepartment of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands., Aart C Hendriks, DirvenClemens M FCMFDepartment of Neurosurgery, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands., and SpoorJochem K HJKH0000-0003-1183-4775Department of Neurosurgery, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands..
• Department of Neurosurgery, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
• Neurosurgery. 2024 Jul 26.

Background And ObjectivesStudying malpractice claims is important to improve quality of health care and patient safety and to educate the individual healthcare providers. The objective of this study was to describe characteristics of neurosurgical claims in the Netherlands.MethodsA nationwide retrospective observational study of neurosurgery-related claims closed by Centramed and MediRisk, 2 major insurance companies in the Netherlands, was performed. Relevant data, including type of neurosurgical pathology, theme and category of the claim, type and severity of injury, outcome, and financial burden, were extracted from anonymized claim files. The estimated annual risk was used to determine the risk for claims by adjusting for the number of annually practicing neurosurgeons in the Netherlands.ResultsA total of 388 claims against neurosurgeons were closed between 2007 and 2021. Liability was denied in a slight majority of claims (n = 230; 59%). The total burden during this period was €6 165 000 (amount paid out to patients: €5 497 000). The estimated annual risk per Dutch neurosurgeon for a claim was 15.5%, meaning 1 claim per 6.5 years. The case-level analysis of 238 available anonymized claims revealed that most claims were related to spinal pathology (81.5%), followed by cranial pathology (10.9%) and peripheral nerve (7.6%). The motivations for filing claims were mostly related to alleged surgical (56.3%) or diagnostic errors (22.3%). Most of these claims were denied (151/238; 63.4%), and fewer were settled (42/238; 17.6%), sustained (31/238; 13.0%), or closed without final decision (14/238; 5.9%).ConclusionNeurosurgery-related malpractice claims primarily involved spinal pathology and were mostly related to alleged treatment errors. Most claims did not result in compensation because there seemed to be no liability or culpable injury. However, the annual risk for a claim for Dutch neurosurgeons is considerable.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.

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