• A Theissen, F Fuz, J Catineau, W Sultan, M Beaussier, M Carles, M Raucoules-Aimé, and P Niccolai.
• Service d'anesthésie réanimation, centre hospitalier Princesse Grace, 1, avenue Pasteur, 98010 Monaco, Monaco. Electronic address: alexandretheissen@hotmail.com.
• Ann Fr Anesth Reanim. 2014 Mar 1;33(3):158-62.

UnlabelledThe medico-legal risk specifically associated with the practice of ambulatory surgery is still not well studied. SHAM insurances are the biggest French provider of medical liability insurances. The study of the insurance claims provided by this insurer is therefore a relevant source of data on the complications related to ambulatory surgery.ObjectiveThe aim of this study was to compare the claim rate related to ambulatory surgery with non-ambulatory surgery.Study DesignWe did a retrospective study on insurance claims provided by SHAM insurances between 2007 and 2011 to compare the claim rate related to ambulatory surgery with non-ambulatory surgery.Materials And MethodsWe searched the files in the SHAM database, and then analyzed them.ResultsOn the study period, out of a total of 29565 registered claims, 467 (1.6%) originated from ambulatory surgery. On the total of 29,098 registered claims for non-ambulatory surgery, 2151 (7.4%) led to a condemnation whereas the rate was 7% (33 out of 467 claims) for ambulatory surgery. The condemnations linked to ambulatory surgery amounted to 1.5% of the total (33 out of 2184), for a cost of 1.7 M€ (versus 400,3 M€ for non-ambulatory surgery). The average cost of a compensation is therefore 50,500 € for ambulatory surgery and 186,000 € for non-ambulatory surgery. The medical specialties concerned are primarily ophthalmology, abdominal and orthopedics surgery. The main identified causes were medical errors (n=16) and nosocomial infections (n=13).ConclusionsThe claim rate in ambulatory surgery is proportionally less frequent with compensations three times less and were related to the most frequent type of surgery done in ambulatory settings. These data should help strengthen quality approach in ambulatory surgery.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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