Neurocirugía y judicialización: estudio observacional de la responsabilidad por daños provocados en la práctica neuroquirúrgica pública en España

Background and objective

Neurosurgery has been internationally considered a "high risk" specialty for lawsuits. The aim of this observational study was to analyze the characteristics of medical liability rulings in Spain for damages caused by the practice of neurosurgery in Spanish public health care.

Materials and methods

Cross-sectional observational study analyzing the rulings handed down in the contentious-administrative jurisdiction by the High Courts of Justice in the period 2008-2020, in the specialty of neurosurgery. The variables were administrative, clinical, judicial, and compensatory.

Results

A total of 1,015 rulings were analyzed, of which 38 (3.74%) were related to neurosurgery. A total of 51.85 % of the judgments were dismissed at first instance and 88.88% at second instance. The most frequent reason in the rulings upholding the compensation requested by the patients was lack of information: 8 (53.33%). The most frequently claimed damage was sequelae: 31 (81.57%). The medical activity most related to the claims was spinal surgery: 23 (60.52%). The median award was 40,000 euros, with a range of 5,000-78,285 euros.

Conclusions

In the Spanish public health system, the specialty of neurosurgery is not among the most demanded. Most of the rullings (60%) reject the compensation requested and, therefore, are favorable to the health services. In the case of an upheld decision, lack of information is the most frequent reason for breach of the lex artis. These data contribute to improving the knowledge of professionals in the medical-legal aspects of health care and invite the formulation of further studies contrasting the Spanish data with those of other countries.