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Aim:   We investigated the death circumstances among children in the Danish healthcare system by analysing closed claims., Methods:   This retrospective study investigated closed claims with regard to medically related deaths registered by the Danish Patient Insurance Association., Results:   From 1996 to 2008, 45 953 claims were made to the Danish Patient Insurance Association (DPIA) covering all medical specialties. Among these claims, a total of 3531 submitted claims were for children younger than 18 years old, and 74 of these children were registered as having died. Forty-one of the 74 deaths were caused by peripartum asphyxia or other birth-related reasons, and 33 children died of causes not related to their birth. Twenty-three of the 33 children died as a result of substandard treatment. This was the ruling of the DPIA or the courts of law on the claim. In these cases, the DPIA, the appeal board or the courts of law settled that an experienced specialist would have acted differently such that the injury could have been avoided., Conclusion:   Twenty-three of the 33 deaths after the perinatal period could potentially have been avoided if experienced specialists had handled the cases., (© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.)

Background: In response to medical treatment, side-effects may occur and the patient may be injured. In Denmark, a patient is entitled to raise a claim for financial compensation and the validity of the claim which, based on defined criteria, is decided by the independent Patient Insurance Association (PIA). In this study, we investigated the files of the patients who were given financial compensation because of an injury caused by an anaesthetic procedure. We wanted to find the sort of injuries and the anaesthetic procedures involved and the size of financial compensation., Methods: A retrospective study of the PIA database from 1996 to 2002 concerning the speciality anaesthesiology., Results: From 1996 to 2002, 18,917 patients made a claim and out of these 916 files were related to anaesthetic procedures, of which 374 cases resulted in financial compensation. In the same period, it is estimated that the total number of anaesthetic procedures was approximately 400,000 per year in Denmark. The primary causes for financial compensation were nerve lesions in response to regional anaesthesia (epidural, spinal, peripheral nerve blockade; n = 132), body positional-related injuries (n = 100), complications due to intravascular catheters or needles (n = 39) and teeth damage during airway handling (n = 31). After anaesthesia, 12 patients' brain functions were impaired probably as a result of prolonged peri-operative hypotension and hypoxaemia. Death occurred in 21 cases. The average financial compensation was 21,500 euros (0.3% of the total amount from all cases) and in 13 cases the injury induced severe patient disability and therefore the compensation was above 1 million DKr. equal to 150,000 euros., Conclusion: In the 6-year period 1996-2002, 374 patients were given in total 8.0 million euros in financial compensation for an injury caused by an anaesthetic procedure. Some anaesthetic complications may result in severe disability whereby the financial compensation to the suffering patients is high. In this study, we estimate that approximately approximately 0.2 per thousand of all patients receiving anaesthesia may develop complications that entitle them to financial compensation.