Medico-legal risk in urology: Analysis of a portfolio of insured persons by a French insurance company between 2009 and 2018

Objective. - Presentation of data collected on urology claims from the register of a French insurance company. Material and method. - Compensation claims involving urologists covering the period 2009-2018 were identified and analyzed. Results. - A total of 37 files were found. Oncological and functional surgical interventions accounts for 78% of repair claims. Postoperative complications represent 76% of the cases. The most represented acts are total prostatectomy (5) and promonto-fixation (4). The average time of complaint is 28.6 months [1-144 months], the average duration of a procedure (opening closing) is 32.8 months [12-72 months]. The Conciliation and Compensation Commissions (CCC) and the High Court Courts (HCC) were solicited respectively in 51% and 33% of the proceedings. An amicable agreement is found in 16% of cases. There was no criminal or disciplinary proceedings. The average cost of a closed urology file is 7836 (sic) [0-31,120 (sic)]. In total, 64.8% of the expertises confirm practices in the respect of the rules of the art. Conclusion. - This series presents the first forensic analysis of a portfolio of urologists on a period of 9 years in French urology. There is a rate of responsibility retained against the practitioner in only 27% of cases. The low rate of faulty files, the absence of a conviction for breach of the duty to provide information and in connection with antibiotic prophylaxis seem to confirm that the practice of urology in France is of good quality, a further study on a longer period of time and on a larger cohort of urologists would allow a finer medico-legal approach. (C) 2018 Elsevier Masson SAS. All rights reserved.