Objective To analyse the number of successful claims against the National Health Service (NHS) involving children, the nature and outcome of incidents leading to litigation and the costs of claims.

Method Under the Freedom of Information Act, details were sought of claims involving children made to the National Health Service Litigation Authority (NHSLA) from 1 April 2005 to 31 March 2010 together with the claim status on 30 September 2010. Closed cases involving financial compensation were analysed in relation to the nature of the incident, outcome and total cost of litigation.

Results 195 closed cases were examined. The commonest causes of litigation were medication or vaccination errors (10), delayed septicaemia diagnosis (8), delayed meningitis diagnosis (7), delayed unspecified sepsis diagnosis (7), extravasation (7), delayed anorectal abnormality diagnosis (6), delayed cardiological diagnosis (6), delayed appendicitis diagnosis (6), epilepsy misdiagnosis (6), psychological/psychiatric effects on parent(s) following a medical error (4), delayed fracture diagnosis (4), gastrostomy related errors (3) and delayed testicular torsion diagnosis (3). The commonest outcomes were death (74), unnecessary pain (35), unnecessary operation (16), brain damage (12), scarring (12), psychiatric/psychological morbidity in parent(s) and/or child (10) and amputation (5). Total costs of litigation ranged from £600 to £3 044 943 (mean £127 975).

Conclusion Delayed diagnosis of severe sepsis is the commonest adverse incident leading to successful litigation and the commonest adverse outcome is 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 decrease these adverse events.