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Litigation in Canada against anesthesiologists practicing regional anesthesia. A review of closed claims

From the Departments of Anesthesia, University of Toronto and McMaster University, Ontario, Canada.

Dr. Kari G. Smedstad, Department of Anesthesia, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada. Phone: 905-521-2100 X 75175; Fax: 905-523-1224; E-mail: smedstad{at}fhs.mcmaster.ca

Purpose: To review the pattern of malpractice litigation related to regional anesthesia in Canada.

Source: The Canadian Medical Protective Association (CMPA) provided with information about all anesthesia claims that closed in the years 1990-1997.

Principal Findings: In the period 1990-97 there were 7,909 closed legal actions involving all CMPA members (56,000). Of these, there were 310 cases involving anesthesiologists, of which 61 cases (approximately 20%) were related to regional anesthesia. Forty-two involved neuraxial blocks, and the legal outcome was favourable (dismissed or judgement in favour of the defendant doctor) in 37 claims. Nineteen claims involved peripheral nerve blocks. All these had favourable legal outcomes. Overall, 10% of regional anesthesia claims have unfavourable outcomes, compared with 28% of all anesthesia related claims and 30% of all CMPA members' claims. The degree of disability in the regional anesthesia claims were: none 10%; minor 49%; major 36%; catastrophic 5%. There were no deaths in the malpractice claims involving regional anesthesia, compared with 17% in the all anesthesia group and 11% in all members' claims.

Conclusion: Twenty percent of all anesthesia claims in Canada are related to regional anesthesia. The legal outcome of these claims is favourable in 90%. Unfavourable clinical outcome is associated with catastrophic or major injury. There were no deaths in the regional anesthesia claims.

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