This page is a collection of examples of reported patient injuries. The aim is to provide a view of the grounds on which a case can be considered to be eligible or not eligible for compensation under the Patient Injuries Act.
However, individual cases of injury can differ very much, so it is not possible to fully determine whether your own case is eligible for compensation based on the examples. Individual circumstances are taken into account in evaluating the eligibility for compensation.
1) Treatment of a fracture during a cruise
A school pupil was going to a cruise as a school trip and tripped when stepping aboard the ship so that he fell over and hurt his arm. He went to see the ship's nurse. The nurse checked the arm and stated that no follow-up measures will be required. A fracture was subsequently diagnosed in the arm
As the treatment was given soon after departure while the ship was in Finnish territorial waters, the Patient Insurance Centre investigated the notice of injury regarding the treatment submitted subsequently by the patient.
2) Surgery performed by a Finnish physician abroad
A Finnish patient agreed to a surgery by a Finnish physician at a clinic in Finland, and said physician performed the surgery later abroad.
Even though both the patient and the physician were Finnish, the Patient Injuries Act could not be applied to the surgery as the operation was not performed in Finland.
1) Daily care provided by a home care worker
An elderly person had been provided with various services to support living at home. A home care worker regularly visited the elderly person to assist in morning and evening chores, cleaning, laundry, helping with eating and taking the elderly person for walks. While the home care worker was walking the elderly person in the living room in connection with the regular day walk, the elderly person fell over and hit his head.
Because the fall took place in connection with daily care, this was not health and medical care referred to in the Patient Injuries Act.
2) Spinal fracture in connection with physical therapy
A patient's leg stuck to a balancing boom during an exercise in physical therapy. He fell on his back, which caused a compression fracture.
This was an accident connected with treatment, in this case physical therapy. The injury was compensated for under patient insurance.
Only personal injuries caused in connection with health and medical care can be compensated for under the Patient Injuries Act.
In accordance with the Act on the Status and Rights of Patients, the terms health care and medical care mean measures taken by health care professionals or in a health care unit in order to assess the state of health of a person or to restore or maintain it.
1) Inappropriate treatment
A patient treated at the inpatient ward of a health centre submitted a notice of injury to the Patient Insurance Centre due to inappropriate treatment by a nurse, which had caused him distress. According to the patient, the nurse had called him offensive names and behaved hostilely towards the patient.
This could not be considered a personal injury referred to in the Patient Injuries Act and thereby eligible for compensation under patient insurance.
2) Mental suffering
The son of a patient who had died of cancer sought compensation under patient insurance as he was of the opinion that the applicant's mother, who was in a weak condition, should not have been told that she had metastatic incurable cancer. According to the son's view, telling his mother about the disease had caused his mother unnecessary mental suffering during her last days.
However, the patient had not suffered a personal injury referred to in the Patient Injuries Act, so no compensation was paid.
Compensation can only be paid for personal injuries. Personal injury usually refers to bodily injury, death or other form of personal injury.
From the point of view of the Patient Injuries Act, a personal injury can be specified as a temporary or permanent impairment of the patient's physical or mental health.
An operation had been performed on a middle-aged woman in May 2010 due to carpal tunnel syndrome, and according to the procedure record, it had been carried out appropriately. In spite of this, the symptoms in her hand continued. It is always possible for symptoms to continue even after a successful operation, and as such, it does not entitle someone to compensation from patient insurance. Resurgery of the wrist had to be made in November 2013, and in it, it was found that the tissues had not been opened sufficiently in the first operation and that the continuation of the symptoms was probably caused by that.
Because the woman had only been informed of the insufficiency of the operation after the resurgery in November 2013, she can submit a notice of injury concerning an insufficient operation performed in 2010 in 2015, even though the operation was performed over three years earlier.
2) Magnetic resonance imaging after surgery
A young male underwent an operation for a herniatic disk on 26 August 2008, after which pain emerged in both his lower back and left leg. He underwent a magnetic resonance imaging study in May 2010, finding scar tissue in the operated area, which was likely to cause the symptoms. He requested compensation for the surgery by way of a notice of injury received on 30 January 2014. He should have understood at the doctor's visit after the MRI in May 2010 that the pains in his lower back and leg were connected to his previous operation and submit a notice of injury within three years of the doctor's visit after the imaging study.
Because the notice of injury concerning the matter was only received later by the Patient Insurance Centre, it was not possible to investigate it.
Sometimes, it is possible that the patient only learns about the injury a long time after it occurs.
A notice of injury received after the expiry of the three-year period can only be investigated under special circumstances. However, compensation must be applied for in any case within no more than ten years after the incident leading to the injury (until 30 April 1999, the expiry period was 20 years).
1) Bleeding after surgery for inguinal hernia
The patient underwent a hernia repair surgery due to inguinal hernia. After the procedure, the patient developed a haematoma in the groin, causing more pain than expected and slowing down recovery.
The hernia repair surgery performed on the patient was medically justified and technically it was performed in an appropriate way. Even though the bleeding was stopped in the surgery, haematoma in the operated area is nevertheless possible. The procedure always involves the risk of haematoma in the operated area, and it cannot be always avoided in spite of appropriate treatment.
Because the procedure was indicated and it was performed appropriately and the consequence could not be avoided in spite of that, this was not a patient injury eligible for compensation.
2) Removal of colonic polyp and intestinal injury
A patient underwent colonoscopic removal of two deformities of the mucous membrane of the colon, or polyps. One polyp was removed by burning and the other one by curettage. The patient developed strong abdominal pain the same evening. A perforation was found in the intestine and corrected in an emergency operation. To repair the intestinal injury, the patient stayed in hospital for approximately a week.
The endoscopy of the mucous membrane and polyp resection performed on the patient were medically justified. Deformities of the mucous membrane in the colon are associated with the risk of a malignant tumour, and therefore the deformities should be checked and removed from time to time.
The intestinal injury emerged in connection with the resection of a polyp by curettage. The level of professional competence of a healthcare professional performing endoscopies and polyp resections was not reached in the technical performance of the procedure because the resected area had been too extensive. The effect of the procedure had also affected the wall of the intestine. The intestinal injury could have been avoided if the procedure had been correct.
The patient was compensated for personal injury caused by the intestinal operation.
3) Gallbladder removal and bile duct injury
A patient underwent gallbladder removal as an endoscopic operation to treat symptoms of gallstones. After the operation, the patient was in pain and was diagnosed with an injury to the bile duct. Bile leaked into the surgery site. The bile leak was successfully repaired with a tube inserted in the bile duct.
The cholecystectomy was a medically justified procedure. However, the level of professional competence for a healthcare professional performing a cholecystectomy was not achieved with regard to the technical performance of the operation. Had the operation been performed technically appropriately, the injury of the bile duct could have been avoided.
The patient was compensated for personal injury caused by the bile duct injury.
1) Temporary vocal cord paralysis after thyroid surgery
A patient underwent thyroidectomy on the left side due to an abnormal specimen collected from the thyroid gland. Immediately after the operation, the patient suffered from hoarseness and the vocal cord nerve was assessed to have been damaged. During the follow-up period, the patient's voice returned to normal.
The partial thyroidectomy on the patient was medically justified. The procedure always involves the possibility of stretch damage due to tissue swelling or handling the nerve and it is not always possible to avoid the stretch damage in spite of the procedure being performed appropriately. However, the functioning of the vocal cord usually returns to normal within a follow-up period of one year after stretch damage.
Because the procedure was indicated and it was performed appropriately and the temporary damage to the vocal cord could not be avoided in spite of that, this was not a personal injury eligible for compensation.
2) Vocal cord paralysis after thyroid gland surgery
A patient underwent a thyroidectomy on the left side due to an abnormal specimen collected from the thyroid gland. The patient was diagnosed with permanent vocal cord paralysis on the left side after the operation.
The partial thyroidectomy on the patient was medically justified. Damage more severe than stretching had emerged in the vocal cord nerve during the operation. It should have been possible to avoid the permanent nerve damage as the tissue structure of the site was otherwise normal, meaning that there was no scarring caused by previous surgeries or, for example, tissue changes caused by cancer. Moreover, the resected section was not exceptionally large.
Because the permanent vocal cord paralysis could have been avoided with more careful surgical technique, the patient was compensated for the personal injury incurred.
LEGS1) Insufficient fixation of ankle fracture
A patient fell over and suffered an ankle fracture that was not fragmented. The fracture was treated by way of surgery and the fractured site was fixed with a plate and screws. During the follow-up period, the healing of the fracture was slow and the ankle was painful. A control X-ray indicated that the fixation of the fracture had not succeeded sufficiently well. The fixation could not prevent an incorrect position from emerging again between the fractured pieces. Had the fixation been carried out appropriately, fracture healing would have been faster and the outcome better.
The treatment of the ankle fracture by way of surgery and metal fixation was medically indicated. However, the level of professional competence of a healthcare professional performing fracture repair surgeries was not achieved with regard to the technical performance of the operation as the fixation of the fracture remained lacking.
The patient was compensated for the personal injury caused by the prolonged healing and outcome that was poorer than expected.
2) Femoral fracture in connection with joint replacement surgery
A patient underwent hip replacement surgery due to arthrosis. A fracture of the upper extremity of femur occurred during the procedure, and resurgery was necessary because of it.
The hip replacement surgery was medically justified to treat the symptoms of arthrosis. The surgery was carried out technically in an appropriate way. A fracture of the upper extremity of femur is always possible in connection with joint replacement surgery. In this case, the fracture could not have been avoided in spite of appropriate treatment. The fracture was observed and the procedures required for treating it carried out during the surgery.
This was not a patient injury eligible for compensation.
1) Wrist fracture, appropriateness of cast treatment
A patient suffered from a fragmented yet non-displaced fracture of the radius, which was treated by casting. Deterioration of position could be observed in the initially non-displaced fracture a week later, and another week later it had deteriorated slightly more. However, the position still remained acceptable. Cast treatment was continued until the ossification of the fracture took place. Pain, weakness, limited range of motion and incorrect position remained in the wrist.
The treatment of the lower extremity of the radius is primarily conservative, i.e. non-surgical. The aim is to return the position by setting it in place (repositioning) and maintain the position with a cast. Surgical treatment is considered if the position of the fracture deteriorates significantly during the cast treatment. The position that can be considered acceptable varies depending on factors such as the patient's general health, age, severity of the fracture and the requirements for the use of the arm.
Even if the treatment outcome of a radius fracture is good, the wrist does not necessarily become symptomless after fracture. A wrist that has fractured into fragments does not usually return to the level of a completely health wrist in terms of functionality.
In the case of the patient, cast treatment was the appropriate choice of treatment, and follow-up was carried out in an appropriate manner. The symptoms remaining after the treatment are the result of both a slight incorrect position and the underlying injury (fragmented fracture). The case does not constitute a compensable patient injury.
2) Wrist fracture, screw fixation, screws extending to the joint
A patient suffered a fracture of the wrist, or radius, when falling over. The fracture was initially treated by casting, but the position of the fracture deteriorated during follow-up. Therefore, it was decided to operate it and fix the fracture using screws. A follow-up X-ray of the fracture indicated that the fracture fixation screws extended to the joint. The patient was operated on again, removing the fixation material.
The fracture operation on the patient was medically indicated, as the position of the fracture had deteriorated significantly during the cast treatment, and cast treatment probably could not have achieved a good outcome. However, the level of professional competence of a healthcare professional performing fracture repair operations was not achieved with regard to the technical performance of the operation. The lengths of the fixation screws should have been selected so that they would not extend to the joint.
The patient was compensated for personal injury caused by the resurgery.
3) Carpal tunnel release surgery, resurgery
A patient had compression of the median nerve in both wrists, causing pain and loss of strength, and therefore he underwent median nerve release operations on both wrists. Recovery was not normal after the surgery. The patient was operated on again, finding that some transverse carpal ligament had remained unopened in both arms and the release of the median nerve had not happened all the way.
The operation on the wrists was medically indicated to release the compression of the median nerve. However, the level of professional competence of a healthcare professional was not achieved as the ligament had not been opened all the way.
The patient was compensated for personal injury caused by the resurgery and prolonged recovery.
4) Carpal tunnel release surgery, clumsiness of the thumb after surgery
A patient suffered symptoms and loss of strength in the left wrist due to compression of the median nerve. He underwent a median nerve release surgery, after which his left thumb remained clumsy. More detailed examinations did not indicate nerve damage, and the post-surgery condition was normal.
The operation on the wrist was medically indicated to release the compression of the median nerve. The technical implementation of the surgery was also appropriate. The clumsiness remaining in the thumb is a possible consequence that is always associated with the operation, and it could not be avoided in spite of the appropriate implementation of the procedure.
The case did not meet the criteria for an injury compensable under the Patient Injuries Act.
5) Diagnosis delay of finger tendon injury
A patient had suffered a laceration from glass in the middle finger. At the ICU, the doctor estimated the wound to be superficial and closed it with sutures. During the follow-up period three weeks after the trauma, it was found that the flexion of the finger was not normal. Tendon injury, probably caused in connection with the original laceration, was found in the finger. The tendon injury was repaired in an operation by a hand surgeon.
The diagnosis of the finger tendon injury was delayed. The tendon injury could have been diagnosed with examinations of the movement of the finger already when the wound was examined.
Because the diagnosis and treatment were delayed due to the examinations being insufficient, the patient was compensated for personal injury caused by the delay. However, the hand surgery would have been necessary in any case, even if the diagnosis was made earlier, so the operation was not compensated for under patient insurance.
1) Lumbar spinal fusion, nerve irritation caused by a fixation screw
A patient underwent L4-5 lumbar spinal fusion due to degenerated disk and hypermobility of the spine. The procedure was otherwise successful, but the patient had pain and irritation in the lower left limb after the operation. Examinations indicated that the left fixation screw of the lower fixed vertebra ("pedicle screw") was partly located in the nerve root canal, irritating the nerve. The left fixation screws were repositioned in the resurgery, resulting in the irritation of the lower limb gradually disappearing.
The lumbar spinal fusion was medically indicated to treat the degenerated disk and hypermobility of the spine. However, the level of professional competence for a healthcare professional performing spinal fusions was not achieved with regard to one fixation screw. The screw extending into the root canal outside the bone could have been avoided by using a more careful operation technique.
The patient was compensated for personal injury caused by the nerve irritation and resurgery.
2) Surgical treatment of spinal stenosis and delayed treatment of haematoma
A patient underwent decompressive surgery of L3-5 for lumbar spinal stenosis. After the operation, the patient was in more pain than normal. In the recovery room phase, the patient reported feelings of numbness in both lower extremities. The motion of the lower limb weakened the following day and the patient could not urinate normally. The sensory disorder increased during follow-up, and the patient was in pain. The situation was monitored, and a decision was made three days later to take new MRI scans and urgent resurgery. Abundant haematoma was found in the operated site and removed. However, the haematoma had already compressed the nerves so that the lower limbs did not fully recover.
The spinal decompressive surgery was medically indicated to treat the spinal stenosis. Surgical treatment always involves the risk of haematoma, and it cannot be always avoided in spite of the appropriate implementation of the procedure. However, the symptoms of numbness in the lower limb, abnormal pain, weakness of the lower limb and urination problems experienced by the patient should have been reacted to faster, deciding on resurgery earlier. This way, the symptoms of paresis in the lower limb could either have been completely avoided or they could have remained slighter. It was estimated that the required level of professional competence in health care was not reached in the post-operative follow-up and evaluation of the need for resurgery. An emergency MRI scan would have been justified 2 days earlier.
The patient was compensated for personal injury caused by the lower limb nerve problems. On the other hand, the resurgery would have been necessary to treat the haematoma in any case, so the resurgery was not compensated for under patient insurance.
3) Spinal disk hernia operation on the wrong disk space
A patient underwent a thoracic spine disk hernia operation on disk space 6-7. After the operation, difficulties walking returned and the previous symptoms exacerbated. A more detailed radiographic examination was performed on the patient, indicating that the operation had been performed on disk space 5-6. The exacerbation of symptoms was successfully stopped with a resurgery on the right disk.
The patient's surgical treatment for disk herniation was medically indicated for the treatment of the degenerative disk disease. The operated space was probably marked incorrectly before the operation. Even though the pinpointing of vertebrae in the thoracic spine region is demanding, it would probably have been possible to reach the correct level by acting more carefully, making it possible to avoid the resurgery and continued symptoms.
The level of professional competence for a healthcare professional performing intervertebral disk hernia surgeries was not achieved in the operation, so the patient was compensated for temporary incapacity caused by the extraordinary surgical procedure.
4) New intervertebral disk hernia soon after surgery
A patient was operated on due to a lumbar intervertebral disk hernia. At first, the outcome of the operation was good. Later, the patient's back became sore again. A new protrusion was found in new examinations in the intervertebral disk space that had been operated on.
The surgery for the intervertebral disk hernia was medically justified and technically it was performed in an appropriate way. Intervertebral disk hernias can recur and cause symptoms, and this cannot be avoided through treatment procedures.
5) Surgical treatment of spinal stenosis, breaking of screws and non-ossification
A patient underwent surgical treatment for spinal stenosis. After the operation, it was found that the screws used for fixation had broken and the fixation point had not ossified as desired. The operation had to be repeated.
The treatment of the spinal canal through ossification was medically indicated. Based on the X-ray images available, it could be estimated that the technical implementation of the surgery had been appropriate.
The breaking of the fixation screw and slowed ossification could not be avoided in spite of the appropriate implementation of the procedure.
1) Dislocation of artificial hip joint, wrong artificial joint components
A patient underwent hip replacement surgery due to painful arthrosis of the hip. The patient did not recover after the operation in the normal way, as the hip joint was dislocated several times. The patient was radiographically imaged, based on which the stem part of the artificial hip joint was too short. Resurgery was performed, replacing the short artificial joint stem with one of the right length. The dislocation problems ceased after this.
The hip replacement was medically indicated to treat the arthrosis. The level of professional competence for a healthcare professional performing hip replacements was not achieved in the operation, when too short a stem part of the artificial joint was selected in the operation.
The patient was compensated for personal injury caused by the dislocations of the artificial joint and resurgery.
2) Hip replacement, dislocations
A patient underwent hip replacement surgery due to painful arthrosis of the hip. The patient's hip was dislocated soon after the operation. At first, the hip could be pulled back in place, but resurgery became necessary due to repeated dislocations. X-ray imaging and resurgery indicated that the parts of the original artificial joint were appropriate. The hip remained painful even after the repeated operation.
The hip replacement was medically indicated. The technical implementation of the operation was appropriate, and the artificial hip joint components selected were appropriate. The reason for the dislocation of the hip could not be determined with certainty. In this case, it was possibly due to weakened muscle structures in the hip region. The operation, which had been performed appropriately using an acceptable method and damaging only little soft tissues, had contributed to this.
This consequence could not be avoided in spite of the treatment having been performed appropriately. The case did not meet the criteria for an injury compensable under the Patient Injuries Act.
3) Knee pain after joint replacement
A patient underwent knee replacement surgery due to wear and arthrosis of the knee. There was still pain in the knee after the operation in spite of rehabilitation and active physical exercise. More detailed examinations on the patient did not indicate the reason for the knee pain.
The knee replacement surgery on the patient had been medically indicated. Based on the report available, the technical implementation of the operation was appropriate. The continuation of the pains was not probably due to the surgical procedure performed.
Appropriate treatment not achieving the desired outcome is not considered a patient injury. In the case of this patient, a painless outcome was not reached in spite of appropriate treatment. Yet, the case did not meet the criteria for an injury compensable under the Patient Injuries Act.
4) Knee replacement surgery, cement residue in the joint
A patient had developed arthrosis in the knee after a previous traffic accident, and therefore a knee replacement surgery was performed. After the operation, there was still abnormal pain in the knee. More detailed examinations indicated that a piece of cement had remained inside the knee joint. The cement piece was removed in a repeated procedure.
The knee replacement was medically indicated to treat the arthrosis of the knee. The knee can remain sore after knee replacement surgery in spite of the appropriate implementation of the operation. However, the patient's pain was caused at least in part by cement residue remaining in the knee region, and it should have been noticed and removed during the operation.
In this respect, the technical implementation of the operation did not meet the level of professional competence required of a healthcare professional performing joint replacements, so the case constituted a patient injury eligible for compensation.
1) Endoscopic repair of anterior cruciate ligament, wrong position of ligament graft
The patient suffered a twisting injury in the accident, and more detailed examinations indicated that the anterior cruciate ligament was torn. An endoscopy of the knee was performed on the patient, and the anterior cruciate ligament was repaired in it using a tendon graft.
The knee continued to be sore and unstable during the follow-up period. A new endoscopy was performed on the patient's knee, finding that the anterior cruciate ligament graft was too anterior on the femoral side. The position of the ligament graft was repaired, after which the pain began to alleviate.
The endoscopy of the knee and ligament repair were medically indicated to treat the anterior cruciate ligament injury. However, the level of professional competence of an experienced physician specialising in endoscopic examinations of the knee was not achieved in the operation, when the canal required for fixing the ligament graft was insufficiently positioned.
The patient was compensated for personal injury caused by the prolonged pain in the knee and the resurgery.
2) Rupture of the anterior and posterior cruciate ligament and collateral ligament, stiff knee after surgical treatment
A patient's knee joint was dislocated in an accident. Ruptures were found in the anterior and posterior cruciate ligament and the medial collateral ligament. The joint capsule was repaired in surgery, medial collateral ligament and cruciate ligaments were fixed to the femur. After the operation, the knee was stable but its motion range was more limited than before. Scar tissue was removed in minimally invasive surgery.
The knee surgery was medically indicated to treat the severe multiple traumas caused in the accident. The technical implementation of the operation was appropriate based on the report available. The trauma was a severe ligament trauma of the knee, which almost always leaves functional impediment in spite of appropriate treatment. Moreover, the formation of scar tissue in the knee could not be avoided in this situation.
1) Cataract operation, posterior capsule rupture
A patient suffered from cataract significantly threatening vision, and it was treated surgically. Before the procedure, the different treatment options were discussed with the patient and surgical treatment was decided on based on the discussion. Following the cataract operation, there was a grey area in the edge of the patient's field of view. A retinal detachment developed in the eye subsequently, and the retina had to be surgically fixed. The patient's eye sight remained poor.
The cataract surgery was challenging because of the dense cataract. The posterior capsule ruptured during the operation. Posterior capsule rupture is a typical complication associated with a cataract surgery, making susceptible to retinal detachment. In most cases, posterior capsule rupture does not result in problems with the eye or eye sight, but in this case the patient had developed retinal detachment possibly caused by the posterior capsule rupture.
The posterior capsule rupture could not be prevented in spite of the completely appropriate implementation of the cataract operation. The retinal detachment resulted in weakened eyesight, even though the fixation of the detachment was also treated appropriately.
Because the complication caused to the patient was not due to insufficient treatment, no compensation was paid under patient insurance.
2) Informing the patient sufficiently prior to LASIK surgery
The patient requested a refractive surgery of the left eye. The operation was indicated and its implementation was appropriate. After the procedure, the patient's vision was good compared to the pre-operative situation. However, the near vision of the eye worsened after the operation because the patient's myopia was changed to almost normal refraction. This was a consequence of the procedure that could not be avoided.
The patient reported not being informed of weakened near vision before the operation. According to the patient, he would not have consented to the operation at all had he been told of the worsening of near vision.
Documents indicated that the patient had been told that he would need reading glasses in the future, even in spite of the operation. The signed agreement on the operation also indicated that the operation has a negative effect on near vision.
It could not be determined based on the investigation that the patient would have refrained from the refractive surgery even if he was aware of the immediate worsening of the near vision of the eye. The patient knew that his near vision would worsen in the future in any case.
The case does not constitute an injury compensable under patient insurance.
3) Informing the patient insufficiently about the adverse effects prior to LASIK surgery
A patient wanted refractive surgery be able to stop wearing glasses. The surgery was performed in a technically appropriate way.
After the operation, one eye was found to be overcorrected, i.e. the patient's near vision had worsened. In addition, he had dry and stinging eyes. Halos occurred in night vision.
The patient had a reoperation of one eye, resulting in his eyesight improving, but the situation was not corrected in other respects. In the notice of injury, the patient reported that he had not been told sufficiently of the risks associated with the operation in advance.
The adverse effects caused by the operation in this case were not common in connection with LASIK surgery. Therefore, it was not usually necessary to inform the patient about them prior to LASIK surgery. However, the patient's age and previous eye disorders increased the probability of adverse effects, and therefore in this case he should have been informed about them prior to performing the operation.
Had the possibility of adverse effects been made known to the patient prior to the operation, he would have probably declined the LASIK procedure, avoiding the adverse effects of the operation.
This was an injury compensable under patient insurance.
4) A LASIK operation did not result in the patient being able to stop wearing glasses
A patient underwent LASIK surgery on both eyes. After the procedure, the patient still needed to use glasses.
The operation was carried out technically in an appropriate way. According to the patient, he did not receive sufficient information before the procedure, and it was only after the procedure that he was told that in case of such short-sightedness, it will not probably be possible to completely get rid of glasses. The physician who performed the procedure reported that he had told the patient of the risks associated with the procedure in advance and also reported having emphasised that the patient’s strong short-sightedness can influence the outcome of the operation. The documents did not include information about any discussions had prior to the procedure.
The patient wanted the operation to get rid of the need to use glasses, but this outcome was not reached with the operation. However, the patient's eyesight improved following the surgery, even though he still needed to use glasses.
Compensation can be paid under patient insurance for personal injury caused to a patient in connection with healthcare or medical care. Personal injury refers to illness, bodily injury or other negative change in health. The need for glasses is not a personal injury and no compensation is paid for it under patient insurance.
Refractory LASIK operations are not absolutely necessary for eyesight. The use of the operation as a treatment method is based on the patient's own choice. Because the procedure is based on non-medical reasons, the significance of appropriate advance information is emphasised. The patient must be given sufficient information about the benefits and risks of the operation before deciding on the operation. The patient must be informed of all significant risks involved in the treatment. However, describing extremely rare risks cannot be required.
With regard to LASIK procedures, it is often a case of contract law. In addition to the notice of injury submitted to the Patient Insurance Centre, the claimant may submit the matter to the Consumer Disputes Board, for example. The Consumer Disputes Board investigates whether the outcome of the operation corresponded with what was agreed upon between the parties from the point of view of contract law.
1) Falling over and wrist fracture in connection with toilet visit
A patient was treated for burns. During inpatient treatment, he fell over when going to the toilet, causing a wrist fracture.
The accident happened while admitted to the inpatient ward. However, the patient moved and functioned independently and was not in need of special supervision or assistance.
In this case, the patient's condition did not require particular supervision or assistance, as the patient had been able to move around the ward independently. The case does not constitute a compensable patient injury.
2) Hip fracture caused while washing oneself
A patient had been in inpatient care for 10 days. A physical therapist had assessed that the patient can move around the word independently using a walker. The patient fell over in the shower, which caused a hip fracture.
The accident happened while the patient was washing himself, and it was not associated with a diagnostic or treatment procedure. The patient's condition was appropriately evaluated to be such that he could move around the ward independently. Therefore, it was not a question of neglecting supervision and the injury caused was not compensated for under patient insurance.
3) Hip fracture caused by insufficient assistance
A patient had been suffering from rheumatoid arthritis for a long time, and it had worsened continuously, finally leading to disability. The patient was at a hospital for examinations, and when moving from one ward to another, he fell over and suffered a hip fracture. At the time of the incident, a nurse was walking ahead of the patient in the corridor. The patient was moving without support or aids.
In connection with the investigation of the case, it turned out that the patient was able to move short distances independently. The patient normally used mobility aids, such as crutches or a wheelchair, but his locomotion did not require continuous assistance by the nursing personnel. However, moving from one ward to another would have required a mobility aid or assistance. Had the patient had an aid in use or been assisted in moving, it would probably have been possible to prevent him from falling over.
This was a case of insufficient assistance and therefore a patient injury eligible for compensation.
4) Head trauma in connection with falling from bed
A patient was admitted to a neurological rehabilitation ward due to skull and brain injury A few months after the beginning of rehabilitation, the patient fell from bed over the side rails. The fall caused a subdural haematoma.
The fall happened suddenly after the patient had already been at the ward for a few months. The only way to prevent the fall would have been to strap the patient to the bed. Strapping is an extreme measure and, based on the patient's condition, no need for it emerged beforehand in this case.
Supervision was appropriate, and the injury caused by the fall was not compensated for under patient insurance.
5) Falling from bed while being moved to a wheelchair
A nurse was moving a patient from bed to a wheelchair. While being moved, the patient's legs slipped and he slid to the floor. The patient needed help in moving due to his health, but otherwise he acted independently. Moving assisted by one person had succeeded without problems before.
This was not an accident related to a diagnostic or treatment procedure, but assisting the patient in daily activities.
No shortcomings could be observed in assisting the patient. The nurse assisted the patient appropriately. The patient's legs giving way completely could not be foreseen. The nurse was able to slow down the patient's fall to the floor by holding him from under the armpits. In this case, there was no need for more than one nurse being there to assist the patient.
It was not an injury eligible for compensation under patient insurance.
6) Tibia fracture in connection with physical therapy
A patient took part in rehabilitation in connection with which he cycled a stationary bike under the guidance of a physical therapist. The patient's knee twisted in hyperextension and he suffered a tibia fracture. Rehabilitation was considered to be a treatment procedure, so the accident took place in connection with healthcare and medical care.
The injury was compensated for under patient insurance.
7) Wrist fracture in connection with riding therapy
A patient fell from a horse in connection with riding therapy guided by a physical therapist. The patient suffered a wrist fracture in the accident. The riding therapy was considered to be a treatment procedure.
8) Hip fracture caused by falling from bed
A patient suffering from memory disease, among other conditions, was treated at a healthcare centre's inpatient ward. The patient fell over bed side rails lifted halfway up. The fall resulted in a hip fracture.
The only way to prevent falling from bed is to strap the patient in place, but it is a measure that strongly interferes with self-determination and is only rarely considered justified. Taking into account the resourced of treatment facilities, it also cannot be usually required that the patients were monitored continuously.
According to the documents, the patient was able to move around independently using a walker, but needed assistance e.g. in washing. Based on the investigation, it was estimated that the supervision of the patient was appropriate. Falling from bed could not have probably been prevented even if the side rails of the bed had been lifted all the way up.
The case does not constitute a compensable patient injury.
1) Ureter damage in laparoscopic hysterectomy
A patient underwent a laparoscopic hysterectomy due to prolonged menstruation, pain and uterine muscle tumour. After the operation, the patient had increasing pain and signs of inflammation. More detailed examinations indicated ureteral injury that had probably been caused in connection with the hysterectomy. An attempt was made to repair the damage by placing a stent in the site of injury, but ultimately it had to be repaired surgically.
The hysterectomy was medically indicated. The operation conditions were normal in the laparoscopic procedure. However, the level of professional competence of an experienced physician specialising in hysterectomy was not reached in the operation. The ureteral injury could have been avoided by using a more careful operating technique.
2) Parts of placenta remaining in the uterus after childbirth
A patient's delivery proceeded normally. After childbirth, the placenta was described to have separated normally and that the placenta was complete. However, the patient required curettage three times because pieces of placenta were found to remain in the uterine cavity.
It is always possible in vaginal delivery that parts of placenta tissue remain in the uterus. Curettage of the uterine cavity may be required several times to remove all placenta material, even if the procedures were carried out appropriately.
3) Intrauterine device dislodged outside the uterus
A patient had an intrauterine device inserted for contraception. The patient had abnormal pain after the intrauterine device insertion. She had an ultrasonography that indicated the intrauterine device to be in the myometrium. The intrauterine device was removed and the symptoms alleviated.
The insertion of an intrauterine device, similarly to all intrauterine procedures, involves the risk of the intrauterine device ending up inside the myometrium or even perforating the uterus. The insertion of an intrauterine device is a "blind procedure", i.e. performed without visual contact. Therefore, perforation of the uterus or the intrauterine device ending up in the wrong place in connection with its insertion is a consequence that cannot always be avoided in spite of the insertion being carried out appropriately.
The treatment of the patient had been medically indicated and the consequence could not be avoided. Therefore, the case did not meet the criteria for an injury compensable under the Patient Injuries Act.
1) Damage of a tooth in connection with intubation
A patient had an endotracheal tube inserted for the duration of general anaesthesia in connection with a medically indicated procedure. The intubation was absolutely necessary to safeguard the patient's respiration and the procedure had been performed in accordance with acceptable treatment practice according to the information obtained. One of the patient's premolars was damaged in connection with the intubation. The tooth in question had previously had four sides filled.
Teeth with healthy periodontium that have not been filled endure the insertion of a tracheal tube and the strain on the teeth that is inevitable while the tube is in place without being damaged. On the other hand, teeth in poor condition, that have weak periodontium and that have many fillings, as well as prosthetic structures, such as bridges or crowns, do not endure strain similarly to healthy teeth.
A tooth in poor condition being damaged in connection with intubation was a consequence associated with the procedure performed on the patient that could not be avoided in spite of the appropriate implementation of the treatment.
2) Nerve injury caused by block anaesthesia
A patient's chipped left molar was repaired under block anaesthesia. Pain and numbness occurred on the left side of the mandible and cheek after the procedure, and opening the mouth was painful. The pains had alleviated six months after the procedure, but the lower lip was still numb. The symptoms were considered to be probably due to damage to the mandibular nerve branch.
The block anaesthesia was performed by way of a "blind injection" without opening up tissue, making it impossible to find out the location of the nerve in relation to the syringe. In this case, the nerve can be damaged either from contact with the needle or injection of the anaesthetic. In addition, tissue pressure caused by the anaesthetic can also cause nerve damage. When anaesthesia is performed using a "blind injection", damage to the nerve is always possible even if the procedure was performed appropriately.
Based on the documents, the treatment received by the patient was medically indicated and it was performed appropriately and in accordance with generally acceptable treatment practice. The nerve damage caused to the patient could not be avoided in spite of the procedure being performed appropriately, so this was not a compensable patient injury referred to in the Patient Injuries Act.
3) Breaking of a needle in a root canal
Root canal treatment was carried out on the patient’s tooth no. 22 (upper left front tooth). During the treatment, the root canal instrument broke in the root canal. Considering that, based on the X-rays, the root canal was not narrow, the Patient Insurance Centre holds that the breaking of the instrument could have been avoided with due care. If the root canal is narrow or markedly curved, it is always possible that the root canal instrument will break during the treatment, even if due care is exercised in performing the treatment. In this case, at issue is a complication that cannot be avoided with a different procedure, and the injury will not be compensated for under the patient insurance.
The patient had to make three additional visits to the dentist because of the injury, the costs of which were compensated for under the patient insurance. Additionally, EUR 200 was paid to the patient as compensation for temporary incapacity.
1) Surgical treatment after Achilles tendon injury and infection
A patient suffered an Achilles tendon injury following a stretching trauma. The tendon was repaired surgically and the limb was placed in a cast. Soon, an infection developed in the operated site. The patient had to stay hospitalised for two weeks for intravenous antibiotic treatment, and a skin transplantation operation was performed on the site of the operation. Following the procedure, the site of infection calmed down, and the infection has not had an effect on the outcome of the treatment of the damaged Achilles tendon.
The repair of the Achilles tendon injury by surgery was medically indicated. The technical implementation of the surgery was also appropriate. Infections were prepared for during the operation by administering anti-infective medication. In spite of this, the infection developing at the site of the operation could not be prevented.
The compensability of the damage caused by the infection is evaluated by taking into account the predictability of the infection, type and severity of the disease or injury being treated, and the severity of the injury caused by the infection and the patient's health in other respects.
Procedures on the Achilles tendon region are associated with an elevated risk of infections of the site of the operation. In this case, the infection could be relieved through antibiotic treatment and skin grafting, and the infection did not have an effect on the outcome of the treatment.
2) Infection after anterior cruciate ligament repair
A patient underwent a corrective operation for anterior cruciate ligament rupture by laparoscopy, and the ruptured ligament was replaced by a ligament graft. An infection developed in the knee region after the operation, and because of it, the patient was hospitalised for intravenous antibiotic treatment, and the site of the operation was lavaged and cleaned several times over three weeks. The ligament graft was lost in spite of this, and a new operation had to be performed later. The functionality of the knee remained unsatisfactory.
The laparoscopic procedure on the knee and the ligament graft inserted in it were medically indicated. The technical implementation of the surgery was appropriate. The infection could not be avoided.
Laparoscopic surgery of the knee in an otherwise healthy patient does not involve significant risk of infection after the operation. In this case, the treatment resulted in the need for surgical cleaning operations and the outcome of the original treatment was lost. The outcome was not good in all respects even after the corrective operation, and this resulted in permanent injury to the patient.
It was an infectious injury eligible for compensation.