Claims and complaints insights: Obstetrics & gynaecology

This claims insight gives an overview of Obstetric and Gynaecology claims.

Monday, 27 March 2023

of both Avant gynaecologists and obstetrician & gynaecologists (O&G) members had a matter raised about the provision of their care each year. Five year average FY2018-FY2022.

Data source: matters indemnified FY2018-FY2022

Regulatory complaints and compensation claims against gynaecologists and O&Gs related to:

Bar graph showing complaints and claims closed FY2018-FY2022.Gynaecological and other proceedures - 49% gynaecologists, 27% Obstetricians and gynaecologistsObstetrics management - 8% Gynaecologists, 34% Obstetricians and gynaecologistsPractitioner behaviour - 13% Gynaecologists, 15% Obstetricians and gynaecologistsConsent - 10% Gynaecologists, 8% Obstetricians and gynaecologistsManagement/Treatment - 6% Gynaecologists, 5% Obstetricians and gynaecologistsOther - 14% Gynaecologists, 11% Obstetricians and gynaecologists

*The analysis below is based on the combined complaints and claims of gynaecologists and O&Gs.

Gynaecological and other procedures

A significant proportion of complaints and claims of gynaecologists and O&Gs were related to gynaecological and other procedures. The stage of care during which these occurred:

Graph showing stage of care with issues: 27% pre-operative, 54% intra-operative, 12% post-operative, 7% Other: Assisted reproduction

Procedures commonly related to reported issues included hysterectomy, reproductive medicine, repair of prolapse of uterus, pelvic floor or enterocele, currettage and evacuation of uterus.

Obstetrics management

Complaints and claims related to obstetrics management occurred in the following stages of care:

Graph showing stages of care: 36% antenatal; 10% labour; 38% delivery; 16% postpartum

Most common obstetric management issues involved caesarean birth procedures, forceps or vacuum delivery, and medical or surgical induction of labour.

Practitioner behaviour

Allegations relating to practitioner behaviour included:

communication, manner and empathy issues 42%
boundary transgression 11%
painful examination 7%.

(% out of total complaints/claims related to practitioner behaviour shown)

Assessment of the care provided (all claims/complaints of gynaecologists and O&Gs)

Bar graph showing 40% below standard care; 60% meets standard of care

Key points

Issues with obstetric management and gynaecological and other procedures were the main sources of complaints and claims for O&Gs.
Half of complaints and claims about gynaecologists related to procedures performed.
Most gynaecological procedure issues arose during the intra-operative stage of care, where poor surgical performance/skill/competence leading to organ damage and adverse events were common allegations.
Most obstetric management issues occurred during the antenatal and delivery stages of patient care.
Gynaecologists and O&Gs met the expected standard of care in 60% of complaints and claims.

The above retrospective review is of routinely collected and coded data. Our review is based on 810 regulatory complaints and compensation claims involving Avant members who are gynaecologists or obstetricians & gynaecologists across Australia. All matters were closed over the five-year period from July 2017 to June 2022 (FY2018-FY2022).

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.
Employment disputes are matters where Avant defends members against complaints or supports members to resolve employment issues.
Medicare matters include Medicare investigations and audits.

Resources

If you receive a claim or complaint, contact us (avant.org.au/mlas) on 1800 128 268 for expert medico-legal advice on how to respond – available 24/7 in emergencies.

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