Claims insights: neurosurgeons

What are the main issues driving neurosurgeon members' compensation claims and complaints? Find out the underlying themes and insights to reduce your risk of these types of claims and complaints.

Wednesday, 16 April 2025

Overview

Practice points

Almost 90% of medico-legal matters were claims for compensation or regulatory complaints.
The reason for most claims were procedural/surgical issues. Allegations of poor surgical performance, skill or competence resulting in complications were most common.
Issues about patient consent such as inadequate discussion of options and risks were often reported in addition to surgical allegations.
Neurosurgeons met the standard of care in over half of claims and complaints against them.

Regularly review your surgical techniques to ensure they are in line with current best practice.
The consent process should involve a discussion so patients understand the potential outcomes, limitations, risks and possible out-of-pocket costs before their procedures.
Peer support may be invaluable when working on complex cases.
Document your discussions.
Avant offers support for neurosurgeons. Read about it here.

^{Incidence and breakdown by type of matter are based on all matters indemnified by Avant for neurosurgeons from FY 2020-24. Underlying themes and assessment of care are based on Avant claims and complaints closed from FY 2020-24.}

1 in 4*

Avant neurosurgeon members per year were subject to one or more matters relating to their provision of health care (*five-year average).

The types of medico-legal matters included claims for compensation (48%), regulatory complaints (40%), coronial (6%), employment disputes (4%) and other matters (3%).

Main issue in claims and complaints

Chart illustrating that the main issue in complaints and claims were procedural/surgical (68%), consent (11%), diagnosis (7%), practitioner behaviour (7%) and other (8%).

Stage of care where surgical issues occurred

Pre-operative (26%) e.g. allegations of improper selection of procedure/surgery/surgical approach
Intra-operative (64%) e.g. allegations of poor surgical performance/skill/competence as a result of complications such as pain or nerve damage; failure, misuse or improper insertion of medical device/prosthesis/fixation
Post-operative (10%) e.g. delay/failure to diagnose complications.

(% of total procedural/surgical issues)

Most common procedures involved in procedural/surgical allegations

Spinal surgeries (74%)

Cranial surgeries (15%)

Most common were:

spinal fusion (e.g. posterior, anterior, posterolateral)
decompression of cervical spinal cord
discectomy
decompression of lumbar spinal canal

Most common was:

removal of intracranial lesion

(% of total procedural/surgical issues)

Consent and communication

While almost 70% of claims and complaints were about procedural/surgical issues, some of these contained more than one allegation.

One in three cases had an additional allegation of poor consent (e.g. inadequate or no discussion of risks, consent not obtained for procedure, treatment or test)
One in six cases had an additional allegation of poor communication (e.g. failure to communicate results/ information to patient, patient or family felt uninformed/condition not explained adequately).

(The above incidences were based on cases that had procedural/surgical issues as the primary allegation and consent or communication issues as secondary allegations.)

Assessment of the care provided

Experts and/or regulators assessed the care provided and found:

Bar chart showing 52% of neurologists were assessed to meet the standard of care and 48% were found to be below the standard.

(% of complaints/claims where the assessment of the expected standards on the main factor is known.)

Glossary

Matters include claims, complaints, coronial cases and other matters such as employment disputes and Medicare.
Claims refers to claims for money, compensation and civil claims.
Complaints relates to formal complaints to regulators including Ahpra, HCCC in NSW and OHO in Queensland.
Employment disputes are matters where Avant defends members against complaints or supports members to resolve employment issues.
Medicare matters include Medicare investigations and audits.

More information

For medico-legal advice, please contact us here, or call 1800 128 268, 24/7 in emergencies.

For any queries on this analysis, please contact us at research@avant.org.au.

MPORTANT: Avant routinely codes information collected in the course of assisting member doctors in medico-legal matters into a standardised, deidentified dataset. This retrospective analysis was conducted using this dataset. The findings represent the experience of these doctors in the period of time specified, which may not reflect the experience of all doctors in Australia. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision-making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published [April 2025].