Malpractice claims for pancreatic cancer in Norway: claim-rates, injury domains, claim outcomes and indemnity compensation

BACKGROUND AND PURPOSE: Pancreatic cancer is difficult to diagnose early and at a curative stage, yet little is known about errors in management. The aim of the study was to investigate malpractice claims in Norway. PATIENTS AND METHODS: All malpractice claims filed to the Norwegian System of Patient Injury Compensation between 2015 and 2024 for pancreatic cancer were evaluated. RESULTS: A total of 148 claims (median 15 [range 8-20] claims/year) were filed among 9548 patients with pancreatic cancer, for an average claim rate of 1.55% (1 claim per every 65 pancreatic cancers). Most claims were filed against hospital/specialists (n = 90), followed by general practitioners (n = 49) with nine claims towards private practice contractors (P < 0.001). A total of 33 claims (22.3%) were approved, of which 28 (85%) concerned delayed diagnosis. Radiology was involved in 18 of the 33 approvals. According to caretaker-level for the malpractice claim, approved claims were 23% for hospital-claims, with lowest approval-rate against general practitioners (12%), and highest against private contractors (66%). Median delay in diagnosis was estimated at 6 months. The outcome of the error was 'death' in 16 of 33. Prognostic loss was determined in five of 33 patients, while 12 patients had no prognostic loss despite an approved claim. Caretaker-level did not differ regarding death or prognostic loss in claims (P = 0.203). A total of 1.47 million EUR was paid in indemnity payments. INTERPRETATION: The claim rate of 1.5% was stable, with about one in five claims approved. Diagnostic delay was the predominant cause, with several stakeholders involved across the healthcare system.