Patient-reported 'treatment injuries' after hand surgery. A review of 1321 claims submitted to the Norwegian system of patient injury compensation 2007-2017.

Objective: Hand surgery makes up a large proportion of procedures, ranging from simple to complex. Increased complexity places greater demand on hand surgery competence. Furthermore, when surgical expertise is not matched to the procedure complexity, treatment injuries might occur. The purpose of this study was to assess patient-reported claims submitted to The Norwegian System of Patient Injury Compensation (NPE).

Methods: We examined all hand surgery claims submitted to NPE between 1 January 2007 and 30 June 2017. NPE records patient demography and variables, such as diagnosis, type of injury, injury location, the reason for the compensation claim, and whether a claim was accepted or rejected.

Results: NPE received 1321 claims related to treatment injuries from hand surgery at a steady rate throughout the study period. A total of 532 claims were accepted (40.3%). The approval rate for trauma cases was significantly higher than for elective cases (45.5 34.2%,  < .05). The most common diagnoses were hand fractures, dislocations and ligament injuries, carpal tunnel syndrome and arthrosis of the first carpometacarpal joint. Tendon injuries had the highest percentage of accepted claims (52.6%). The most common reason for claims being accepted was 'failure of treatment'. 19.7% of these involved a disability percentage >15%. Elective surgery accounted for ⅔ of the approved disability cases.

Conclusions/interpretation: This is the first national study of patient-reported injuries after hand surgery treatment in Norway. The proportion of accepted claims is similar to that seen for orthopaedics. Acceptance levels were, however, higher for hand trauma cases than for disorders treated electively.

Abbreviations: NPE: Norwegian system of patient injury compensation; SD: standard deviation; CT: computed tomography; MRI: magnetic resonance imaging; UiT: University of Tromsø - Arctic University of Norway.