Iatrogenic patient injuries in otology during a 10-year period: review of national patient insurance charts

Abstract

Objective: To assess patient injury characteristics and contributing factors in otology.

Methods: Data on the accepted patient-injury claims involving otorhinolaryngology (ORL), closed between 2001 and 2011, from the Finnish Patient Insurance Centre registry was retrieved. We included all injuries concerning otology, with evaluation and classification of their causes and types.

Results: During the 10-year study period, a total of 44 claims were accepted as compensated patient injuries in otology. From a total of 233 patient injuries in all ORL, this amounted to 19%. In outpatient care, occurred 12 (27%) injuries and in surgical procedures 32 (73%). Five (11%) patients were children. Errors in surgical technique were identified as the primary cause of the injury in 22 (69%) operation-related cases. Failure to remove all auricular tampons or packing in postoperative control was a contributing factor in 4 (13%) injuries, a facial nerve was damaged in 9 (28%) operations, and in 12 (38%) patients, the injury resulted in severe hearing loss or deafness. Six patients (21%) needed one or more re-operations related to the injury, of which two were due to an incomplete primary operation.

Conclusion: Typical compensated patient injuries in operative otology resulted from common complications of common operations in high volume centres.

Chinese abstract

目的：评估耳科患者的损伤特征和病因。

方法：从芬兰病人保险中心登记处获得2001年至2011年期间的涉及耳鼻咽喉科（ORL）的病人-损伤索赔的数据, 包括所有耳科伤害及其原因和类型的评估和分类。

结果：在10年的研究期间, 共受理了44项索赔, 补偿耳科患者的损伤。在所有ORL中, 共有233名患者受伤, 达19%。在门诊护理中, 发生12例（27%）受伤, 外科手术中发生32例（73%）。 5例（11%）患儿为儿童。 22例（69%）手术相关病例的手术技术误差被确定为受伤的主要原因。手术中未能清除所有耳塞或包装, 造成4例（13%）损伤, 9例（28%）患者面部神经受损, 12例（38%）伤害造成严重的听力损失或耳聋。 6名患者（21%）需要一次或多次与损伤有关的再次手术, 其中2例因初次手术不完全而发生。

结论：耳科手术的典型受赔患者受伤是由于大流量医疗中心常规手术的常见并发症。

Keywords:

• Patient injury
• patient safety
• adverse events
• otosurgery

Disclosure statement

Päivi Helmiö has received honoraria from Helsinki University Hospital Research Fund. For the remaining authors, none were declared.

Additional information

Funding

Päivi Helmiö has received honoraria from Helsinki University Hospital Research Fund.