Cost of claims for maternity-related incidents soars by 80%

The cost of maternity-related claims has jumped 80% from €32m to €58m between 2010 and 2014, representing over half of all clinical care-related claims.

The most common maternity claims were perineal tear, a baby’s shoulder becoming trapped during birth (shoulder dystocia), stillbirth, unexpected neo-natal death, cerebral irritability/ neonatal seizure, and ‘other’.

According to a report by the State Claims Agency, analysing clinical incidents and claims in maternity and gynaecology services, the expenditure on cerebral palsy claims was also found to have increased by 77% from €27m to €47m between 2010 and 2014.

However, the agency said the increase was primarily due to people receiving lump- sum payments instead of certain previous periodic payment orders, and to the cumulative effect of the greater use of periodic payment orders over time.

The report said incident rates in Irish maternity services are similar to international figures where comparisons are available.

It said while 75 clinical incidents out of 9,787 rated as “extreme in severity” were reported to the National Incident Management System in 2014, these were not all avoidable clinical incidents.

Some related to unavoidable natural events, significant congenital anomalies or mis-categorisation regarding severity factor.

The National Incident Management System was introduced in 2014 after the Savita Halappanavar case and, since June of this year, all incidents in the healthcare sector are now being reported directly to the National Incident Management System.

However, it said the claim count has remained either static or has reduced since 2012 for these categories.

The agency also found that a variation in patient safety incident reporting exists nationwide and that a lack of standardisation exists regarding reporting of severity of injury for patient safety incidents.

As a result, a backlog of incidents to be notified to the agency exists in just over half of acute hospitals (52%). The volume of backlog is less than 100 incidents in 12 hospitals but greater than 500 in six hospitals.

With regard to gynaecology services, the six most common incidents between 2010 and 2014 were unplanned re-attendance and missing or misplaced clinical records. Following an examination of 10 years of closed medico-legal claims for retained foreign bodies, the agency found there were 30 claims in this category nationally in maternity and 14 in gynaecology services between 2004 and 2014.

Agency director Ciarán Breen said the report would help identify areas for improvement in maternity and gynaecology services.

“However, this report is valuable because it analyses crucial information on adverse event reporting in maternity and gynaecology services,” he said. “This information assists in the identification of adverse trends and areas for improvement in the maternity and gynaecology services.”