Characteristics of claims in the management of septic arthritis in Japan: Retrospective analyses of judicial precedents and closed claims

• Published in: Journal of the Chinese Medical Association 2018-03, Vol.81 (3), p.236-241
• Main Authors: Otaki, Yasuhiro, DaSilva, Makiko Ishida, Saito, Yuichi, Oyama, Yasuaki, Oiso, Giichiro, Yoshida, Tomohiko, Fukuhara, Masakazu, Moriyama, Mitsuru
• Format: Article
• Language: English
• Subjects: Arthritis, Infectious - therapy; Closed claim; Humans; Japan; Malpractice; Medical Errors; Precedence; Retrospective Studies; Septic arthritis
• ISSN: 1726-4901; 1728-7731
• DOI: 10.1016/j.jcma.2017.06.023

Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated. We also studied 5 accident and 21 incident reports of SA based on project data compiled by the Japan Council for Quality Health Care. The rate of negligence was 83.3% in the precedents and 75.0% in closed claims. Two main malpractice claim patterns were revealed: SA in a lower extremity joint following sepsis caused by methicillin-resistant Staphylococcus aureus in newborns and SA in an injection site following joint injection. These two patterns accounted for 83.3% and 56.3% of judicial cases and closed claim cases, respectively. Breakdowns in care process of accident and incident reports were clearly differentiated from judicial cases or closed claim cases (Fisher's exact test, p