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Claims and complaints insights Orthopaedic surgeons

Summary: Members asked us for more information about compensation claims and complaints to regulators. In response the following is a retrospective review of routinely collected data.

Thursday, 9 June 2022

1 in 6 Avant orthopaedic surgeon members had a matter raised about the provion of their care.
Pie graph of the types of matters.

Regulatory complaints and compensation claims against orthopaedic surgeons related to:

bar graph

The stage of care during which procedural/surgical issues occurred

25% Pre-operative
e.g. improper selection of surgical procedure/approach, refusal/failure to perform procedure, improper selection of medical device/prosthesis/fixation

55% Intra-operative
e.g. Poor surgical performance/skill/competence, failure/misuse or improper insertion of medical device/prosthesis/fixation

20% Post-operative
e.g. delay/failure to diagnose complication, poor performance/skill

Practitioner behaviour issues

Allegations relating to practitioner behaviour included:

  • Failing to communicate results and information appropriately to patients or other providers/staff (16%)
  • Rudeness, poor attitude or lack of empathy towards p a t i e nt s (16%)
  • Boundary transgressions (14%)

Management/treatment issues

Allegations relating to management/treatment issues included:

  • Treatment plans (56%) e.g. delay/failure/refusal to instigate an appropriate treatment plan
  • Ongoing assessment issues (33%)

Diagnosis issues

Allegations relating to diagnosis were more likely to be of a missed or delayed diagnosis (76%) during initial assessment or follow-up, than a misdiagnosis.

The above retrospective review is of routinely collected and coded data. Our review is based on 317 regulatory complaints and compensation claims involving Avant members who are orthopaedic surgeons across Australia. All matters were closed over the five-year period from July 2016 to June 2021 (FY2017-FY2021).

Complaints: Outcomes for orthopaedic surgeons

bar graph of complaints data

Key points

  • Medico-legal matters against orthopaedic surgeons are relatively common.
  • Orthopaedic surgeons are more likely to be sued for compensation than to be subject to a disciplinary complaint, although complaints still make up 36% of matters.
  • The majority of compensation claims and regulatory complaints were related to procedural/surgical issues and half of these occurred during the intra-operative stage of care.
  • The majority of regulatory complaints against orthopaedic surgeons were dismissed.

Notes on the outcomes analysis

This analysis was conducted on regulatory complaints filed against orthopaedic surgeons who are Avant members over the five-year period from July 2016 to June 2021 (FY2017-FY2021). Only complaints with a known outcome were included.

The outcomes were classified based on the degree of severity for members. Shown below are some of the types of outcomes in each category.

  • Dismissed – e.g. discontinued, no further action
  • Low severity – e.g. counselled, caution, conciliation, resolution, fine
  • Medium and high severity – e.g. reprimand, conditions, registration changes, suspension, cancellation

Glossary

  • Claims refers to claims for money, compensation and civil claims.
  • Complaints/regulatory complaints relate to formal complaints to regulators e.g. Ahpra.
  • Medicare matters include Medicare investigations and audits.
  • Employment disputes are matters where Avant defends members against complaints or supports members to resolve employment issues.
  • Matters include: claims, complaints, coronial cases and other matters such as employment disputes and Medicare.

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

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