Introduction All National Health Service (NHS) Trusts in England are covered by the Clinical Negligence Scheme for Trusts (CNST). The NHS Litigation Authority (NHSLA) is the body that handles the claims made against the NHS and it receives numerous claims relating to children each year. Approximately 96% of claims are settled out of court.
Aim To analyse the number of successful claims against the NHS involving children, the nature and outcome of the incidents leading to litigation and the costs of claims.
Method A record of claims involving children made to the NHSLA was obtained under the Freedom of Information Act. Cases reported to the NHSLA under the CNST from the 1 April 2005 to 31 March 2010 together with the status of the claim on the 30 September 2010 were listed. The number of closed cases in the last 5 years in which the claimant received financial compensation were analysed in relation to the nature of the incident, the outcome and the total costs of the action.
Results There were 196 closed cases over this 5 year period. The commonest causes of litigation were drug or vaccination errors 10, delayed diagnosis of septicaemia 8, delayed diagnosis of meningitis 7, delayed diagnosis of unspecified sepsis 7, extravasation 7, delayed diagnosis of an anorectal abnormality 6, delayed cardiological diagnosis 6, delayed diagnosis of appendicitis 6, misdiagnosis of epilepsy 6, psychological/psychiatric effects on the parent(s) following a medical error 4, delayed diagnosis of a fracture 4, gastrostomy related errors 3 and delayed diagnosis of testicular torsion 3. The commonest outcomes were death in 74 cases, unnecessary pain 34, unnecessary operation 16, scarring 13, brain damage 12, psychiatric/psychological morbidity to the parent(s) and/or child 10, and amputation in 5 cases. The total cost of the litigation ranged from £600-£3044943 (mean £157945).
Conclusion Delayed diagnosis of severe sepsis is the commonest adverse incident leading to successful litigation and the commonest adverse outcome is a death. The cost to the NHS is considerable. A better understanding of the causes of common errors in paediatrics should inform training and help to diminish these adverse events.