Reasons for patients' discontent and litigation

Introduction: Discontent and litigation among patients is a problem which i ncreasingly preoccupies the medical profession. Aim: We aim to analyse the origin of discontent and Litigation and to help avoiding these claims, Mate rial: One hundred and seventy-eight medical expert opinions were evaluated, all made following examination of the complainant, Methods: Depending on t he results of the clinical examination and the study of the files it was de termined whether there was either a case of malpractice or insufficient inf ormed consent, or no fault at all in a legal sense. In addition the patient and the surgeon were questioned as to their point of view regarding the pr ocedure and their communication and relationship before and after treatment . Results: Frequent complaints were pain (either during treatment or afterw ards), major swelling or bleeding, disturbances of trigeminal or facial ner ve function, poor scar formation, loss of teeth or fixtures, faulty occlusi on and discrepancies between the expected and the actual result of treatmen t. In 26 cases actual faults made during medical treatment were discovered. In 49 further cases, poor explanation of the proposed procedure was the re ason for complaint. In the majority of remaining cases, neither faulty trea tment nor insufficient information given to the patient lead to the complai nt but the patient's expectations were unrealistically high, Conclusion: A considerable proportion of lawsuits originate from misunderstandings, and n ot treatment errors: The surgeons often concentrate on the legal requiremen ts of informed consent and neglect to explain the practical consequences of the operation; the patients in turn tend not to ask about possible complic ations, (C) 2001 European Association for Cranio-Maxillofacial Surgery.