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Low rates of medical misadventure claims for GPs

ACC needs to be more realistic when talking about medical misadventure claims against GPs, says the New Zealand Medical Association. ACC's recent criticisms regarding "underreporting" are misguided.

Figures released by ACC show only 320 claims against GPs for medical misadventure have been accepted in the last eight years. During that time, the NZMA conservatively estimates that more than 100 million GP consultations have taken place. 320 claims are a minuscule number compared with the total.

"The NZMA welcomes these figures, which show that people can continue to have faith in their family doctor," said NZMA Chairman Dr Pippa MacKay. "Thousands of procedures are carried out in surgeries around New Zealand every day, and these figures show that only 40 a year result in a medical misadventure claim.

"Every death is a tragedy, and every adverse health event has a negative impact for those involved. But medicine is not a perfect science, and complications do occur. It is unrealistic to expect otherwise.

"We acknowledge that ACC claims may not have been made for some cases, but even if the claim figure was doubled, it would still be tiny compared with the huge number of GP consultations."

When you take out medical mishaps (severe complications which occur despite treatment being carried out correctly), the figures are even lower. Only 163 claims of medical error against GPs were accepted in the last eight years - an average of less than 21 a year. Of the medical error claims, only 8.5 percent happened in the last two years.

One serious error, that of misdiagnosing meningococcal meningitis, can result in death. Meningococcal meningitis is rare and difficult to diagnose correctly. Most GPs never see it. New Zealand has one of the lowest death rates from meningococcal meningitis in the world (less than 5 percent of cases here are fatal, about half that of the UK, and about half of what is expected in the Western world).

ACC's suggestion that meningococcal meningitis is being underreported does not acknowledge the significant work being carried out by doctors and hospital staff to ensure an extremely low death rate from this epidemic, Dr MacKay said.

ACC Definition of Medical Misadventure

To be covered by ACC under "medical misadventure", a person's injury must meet the definition of either "error" or "mishap".

* Error is defined as the failure of a registered health professional to observe a standard of care and skill reasonably to be expected in the circumstances. Error may involve failure to diagnose, failure to treat, or failure to gain informed consent from a patient.

* Mishap is defined as an adverse consequence of properly given treatment. The adverse consequence must be severe and it must be rare. Severe means that the treatment must result in either hospitalisation for more than 14 days, a significant disability for more than 28 days, or death. Rare means that the adverse consequence of treatment would not occur in more than 1 percent of cases in which treatment is given.

(Medical misadventure is a complex area, and the NZMA believes it is vital for reporters to understand the difference between medical mishap and medical error. The terms are not interchangeable. Mistakes made by doctors come under medical error. Unavoidable complications are medical mishap).

ENDS

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