Litigation in Canada against anesthesiologists practicing regional anesthesia. A review of closed claims

Purpose: To review the pattern of malpractice litigation related to regiona l anesthesia in Canada. Source: The Canadian Medical Protective Association (CMPA) provided with in formation about all anesthesia claims that closed in the years 1990-1997. Principal Findings: In the period 1990-97 there were 7,909 closed legal act ions involving all CMPA members (56,000). Of these. there were 310 cases in volving anesthesiologists, of which 61 cases (approximately 20%) were relat ed to regional anesthesia. Forty-two involved neuraxial blocks, and the leg al outcome was favourable (dismissed or judgement in favour of the defendan t doctor) in 37 claims. Nineteen claims involved peripheral nerve blocks. A ll these had favourable legal outcomes. Overall, 10% of regional anesthesia claims have unfavourable outcomes, compared with 28% of all anesthesia rel ated claims and 30% of all CMPA members' claims. The degree of disability i n the regional anesthesia claims were: none 10%; minor 49%; major 36%; cata strophic 5%. There were no deaths in the malpractice claims involving regio nal anesthesia. compared with 17% in the all anesthesia group and 11% in al l members' claims. Conclusion: Twenty percent of all anesthesia claims in Canada are related t o regional anesthesia. The legal outcome of these claims is favourable in 9 0%. Unfavourable clinical outcome is associated with catastrophic or major injury. There were no deaths in the regional anesthesia claims.