The impact of adverse events and litigation on clinicians

A survey of 1011 North Thames clinicians found that over 70% of consultants or senior registrars had been sued in some high risk specialties, 79% in orthopaedics and 76% in obstetrics [1]. Although risk management programmes were, in 1994, seldom mentioned specifically, there was strong support for a proactive approach to adverse events in which many of the themes of risk management, such as early explanation and intervention with injured patients, were advocated [1,2,3]. The need for staff support is also apparent. 19% of the senior clinicians had considered giving up their medical careers as a result of their experiences of litigation [1]. Studies of junior doctors' mistakes suggest that making a serious mistake can be one of the most stressful events in a doctor's career, especially if they are not support ed by colleagues and, where litigation is concerned, by managers. The impact of adverse events, complaints and litigation has been further explored in a recent chapter [4].

1. Bark P, Vincent CA, Olivieri L, Jones A. Impact of litigation on senior clinicians: implications for risk management. Quality in Health Care 1997; 6:7-13.
2. Vincent C, Bark P, Jones A, Olivieri L. The impact of litigation on obstetricians and gynaecologists. Journal of Obstetrics and Gynaecology 1994; 14:381-7.
3. Vincent CA, Olivieri L, Bark P, Jones A. Psychiatrists' views of litigation and risk management. Clinical Risk 1996; 2:103-6.
4. Vincent CA. Fallibility, uncertainty and the impact of mistakes and litigation. In Firth-Cozens J. and Payne R, (eds.) Stress in Health Professionals (3rd edition). Wiley (in Press).

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