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Claims for compensation from women with cervical cancer in Norway-A retrospective, descriptive study of a 12-year period.

Authors
  • Ravlo, Merethe1, 2
  • Lieng, Marit3, 4
  • Khan Bukholm, Ida Rashida5, 6
  • Haase Moen, Mette1
  • Vanky, Eszter1, 2
  • 1 Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. , (Norway)
  • 2 Department of Obstetrics and Gynecology, St. Olav's Hospital, University Hospital of Trondheim, Trondheim, Norway. , (Norway)
  • 3 Department of Gynecology, Oslo University Hospital, Oslo, Norway. , (Norway)
  • 4 Institute of Clinical Medicine, University of Oslo, Oslo, Norway. , (Norway)
  • 5 Norwegian System of Patient Injury Compensation, Oslo, Norway. , (Norway)
  • 6 Norwegian University of Life Sciences (NMBU), Oslo, Norway. , (Norway)
Type
Published Article
Journal
Acta Obstetricia Et Gynecologica Scandinavica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Nov 01, 2020
Volume
99
Issue
11
Pages
1546–1553
Identifiers
DOI: 10.1111/aogs.13930
PMID: 32491192
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In Norway, all patient-reported claims for compensation are evaluated by The Norwegian System of Patient Injury Compensation (NPE). The number of claims from women with cervical cancer is rising, and the approval rate is high. Our aim was to study claims for compensation from women with cervical cancer to identify the type of failures, when, during the time-course of treatment, the medical failures occurred, and the consequences of the failures. A retrospective, descriptive study of claims for compensation to NPE from cervical cancer patients during a 12-year period, from 2007 through 2018. We used anonymized medical expert statements and summaries of NPE cases. In all, 161 women claimed compensation for alleged medical failure related to cervical cancer. Compensation was approved for 100 (62%) women. Mean age at the time of alleged failure was 37.5 years (SD ±9.9). The main reasons why women sought medical attention were routine cervical screening (56%), or vaginal bleeding or discharge (30%). In approved cases, incorrect evaluation of cytology and histology was the cause of most failures (72%). Mean delay of cervical cancer diagnosis for approved cases was 28 months (SD ±22). Treatment not in accordance with guidelines was the cause of failure in 2% of the cases, and failure during follow up was the cause of failure in 12%. Consequences of the failures were as follows: worsening of cancer prognosis (89%), treatment-induced adverse effects, such as loss of fertility (43%) and/or loss of ovarian function in premenopausal women (50%), and permanent injury after chemo-radiation (27%). Seven women (7%) died, most probably as a consequence of the failure. The main cause of medical failure in women with cervical cancer was incorrect pathological diagnosis. The main consequences of failures were worsening of cancer prognosis and treatment-induced adverse effects. Increased focus on the quality of pathological examinations, and better routines in all parts of the cervical examinations might improve patient safety for women in risk of cervical cancer. © 2020 Nordic Federation of Societies of Obstetrics and Gynecology (NFOG) Published by John Wiley & Sons Ltd.

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