Adverse events in intensive care medicine. An analysis from the arbitration board for medical liability issues of the Northern German Medical Associations from 2006 to 2020

Background: The analysis of adverse events (AE) and preventable adverse events (PAE) is essential to improve pa - tient safety. The prevalence of AE and PAE in surgical and non-surgical intensive care medicine has not been analysed in Germany.Method: Medical claims cases (01.01.2006 to 31.12.2020) of the Arbitration Board of the North German Medical Associations were analysed. Statistical analysis comprised the rela-tive and absolute frequency of AE and a comparison of AE in various medical specialties by chi square test or Fisher acute accent s test (p < 0.05).Results: During the study period 34,120 medical claims were completed by the Arbitration Board of the North German Medical Associations. 221 medical claims (0.6 %) were attributed to in-tensive care medicine and analysed. 30 cases had to be excluded for mis-classification, inadequate information to assess the claim or to determine its relation to intensive care medicine. Pu-tative malpractices were related mainly to the categories of sepsis / infection, respiratory failure, positioning/nursing practice and treatment of acute haemor-rhage / circulatory failure. In 36 cases (18.8 %) the Arbitration Board of the North German Medical Associations asserted malpractice causing health damage. Substandard treatments for sep-sis / infection (28.6 %) and circulatory failure (17.1 %) were significantly cor-related with a lethal outcome (Fisher acute accent s exact test, p = 0.003, Cramer coefficient V = 0.27).Conclusion: Analysis of preventable ad-verse events in intensive care medicine may define key points to improve patient safety.