Patient injuries in tonsil and adenoid surgery in Finland

Studies have shown that patient injuries in Otorhinolaryngology are relatively few and are mostly related to operative care. The aim of this study was to examine patient injuries related to tonsil and adenoid surgery by reviewing patient injury claims sent to national Patient Insurance Centre in Finland. Study design A retrospective register-study. Methods Complaints related to tonsil or adenoid surgery that were received by Patient Insurance Centre between the years 2000–2019 were analyzed. The annual rates of tonsil and adenoid surgeries in Finland were acquired from the Finnish Institute for Health and Welfare. Results In the 20–year study period a total of 172 claims regarding tonsil and/or adenoid surgery were processed in the Patient Insurance Centre. 56 of these (32.6%) were compensated. 53 claims (30.8%) involved children (aged 1–15), 17 of these were compensated (32.1%). The majority of the claims were made after tonsillectomy (n=151, 87.8%) and only few after tonsillotomy (n=3, 1.7%). One third (32.6%) of claimants were operated on in university hospitals and one third (35.5%) in central hospitals. The most common compensated patient injury was a burn (26.8%) followed by nerve injury (14.3%). The most common complaint in claims (compensated or not) was related to the altered anatomy of the pharynx (16.3%), and the second most common to post-operative hemorrhage (14.5%). There were 7 cases of death which were all compensated. Conclusions Patient injuries of tonsil and adenoid surgery are mainly related to traditional total tonsillectomy. Our data suggests that most complications in tonsil or adenoid surgery involve experienced professionals during office hours in routine operations in high volume centers. Giving added patient information to patients that require general anesthesia to control post-tonsillectomy hemorrhage could reduce unnecessary patient injury claims that will not be compensated