Medical accidents: 6 out of 10 disputes concern surgeons

Surgery is the specialty that generates the most medical accidents considered to be “major claims”. The average amount of compensation is around 120,000 euros per case.

They are called the “big claims”. In its seventh report for the years 2009 to 2014, theObservatory of medical risks (ORM), placed with the ONIAM (1) draws up a table of nearly 9,400 medical accident files for which the overall amount of damage (the compensation paid to the victim plus the support of third-party payers) was equal to or over 15,000 euros and closed.

And good news, their number has been decreasing overall since 2009 with however a peak in 2010. The authors specify that this variation is linked to the periods of compensation but is not identical according to the sources of the files (AP-HP, insurers, etc.) Here is the classification of the specialties most concerned.

Surgeons first

First of all, the report indicates that the average compensation amount is in a range between € 35,000 and € 180,000 (excluding disciplines for which the number of cases is not significant: pharmacists). “The trends observed are in line with those observed in 2013”, it is written.

Thus, the largest compensation amounts relate to surgical disciplines (excluding obstetrics and cosmetic surgery) with a total amount of 673 million euros. and nearly 62% of cases processed. They even covered up to 69% of indemnified cases in 2014!

The average amount of these files is over € 119,000. Next comes the anesthesia, resuscitation, emergency and regulation group with a total amount of more than 87 million euros for 559 cases. 455 cases concern obstetricians with a total compensation amount of over 61 million euros, or 134,856 € on average per case.

Finally, medical disciplines without invasive acts close this classification with a total amount of more than 126 million euros for 994 cases. On the responsibility of these professionals, the ORM underlines that the rate of technical fault remains relatively stable (with a decrease in 2011), while the rate of non-faulty acts increased until 2013.

Amicable and jurisdictional procedures

In addition, the study of the nature of the compensation made by the Observatory shows that, as in previous years, most of the overall compensation amount paid is settled out of court (60%).
The average compensation amount paid for court cases is presented as “increasing”. Procedures which are mainly carried out by women (53%) during the year of the act in question (63%). “This proportion is increasing, thus testifying to the better knowledge of victims of the avenues available to them to request compensation”, rejoices the ORM.

Nature of the claim

Finally, the rate of nosocomial infection cases compensated by insurers, which represent 17% of all cases, has been increasing for 3 years. The total compensation amount (144 million euros) is borne at 69% (rate which has also increased for 3 years) by insurers and at 28% by ONIAM.

A surprising conclusion since, last year, nosocomial infections were announced as decreasing, even if the figures still lacked transparency … This is indeed what the association, Le Lien, deplored during the 5th General Assembly health care safety which denounced an “omerta” around medical accidents and called for more precise indicators.

According to the Institut de Veille Sanitaire (InVS), one in 20 patients contracts a nosocomial infection in hospital. Deaths are estimated at 4,000 per year.