An analysis of closed claims related to death in the Danish health care system

Abstract

Studies based on closed claims are important in our efforts to improve patient safety. The 
circumstances of the worst possible outcome of medical treatment: patient deaths from a complication 
to treatment were investigated. This retrospective study investigated closed claims concerned with 
medical-related deaths registered by the Danish Patient Insurance Association (DPIA). The present 
study used data from all reported complications from medical treatment in the primary health care and 
hospitals setting in Denmark. The results revealed from 1996 to 2008, 45,953 claims were made to the 
DPIA covering all medical specialties. Of these, 836 patients died as a result of treatment or lack of 
treatment. The total cost of the 836 claims was 40.0 million € corresponding to an average 
compensation of 59,300 € per approved case (range: 1,500 -1,200,000 €). The majority of deaths 
involved generally healthy patients. Almost every clinical speciality reported deaths as a result of an 
adverse event. Surgery accounted for the largest group of deaths, with 279 deaths occurring as a direct 
result of surgical treatment and 145 deaths caused by surgical treatment that came too late or no 
surgical treatment at all despite valid indications. Fifty-four patients died as a result of substandard 
treatment in primary care, and 782 patients died as a result of treatment at a hospital. Of the 836 
submitted claims, 435 deaths were considered by the DPIA or the courts of law as a result of 
substandard care and considered preventable. This study thus gives an overview of the claims 
concerning deaths in the Danish healthcare system.