Cost of active ACC claims for injuries caused by omission of medical treatment in New Zealand

An active claim is a claim that is open and has received a payment in that financial year. The claim could be a new claim accepted during that year or an existing claim.
Costs provided are exclusive of GST.
Costs are based on payment date. Payment date may be different to the date of service.

ACC: Accident Compensation Corporation
Treatment injury (injury caused by medical treatment): a personal injury caused by treatment from, or at the direction of, a registered health professional. This includes diagnosis, advice and interventions and failure to provide treatment or failure to provide treatment in a timely manner. The injury must have been caused by treatment; but not be a necessary part, or ordinary consequence, of the treatment.
Ethnic group: a claim can only have one ethnicity based on their selections on the ACC45 claim lodgement form. A maximum of six ethnicities can be chosen by the client. The system prioritises these where Māori, regardless of other ethnicities are classified as Māori, Pacific Peoples with any other responses other than Māori are classified as Pacific; Asian peoples with any other response other than Māori and Pacific are classified as Asian and Other Ethnicity regardless of any other response other than Māori, Pacific or Asian are classified as Other. Those that listed European and did not list Māori, Pacific, Asian or Other are classified as European. Residual Categories are those whose ethnicity was not stated. The 'other' ethnicity category includes MLA (Middle Eastern, Latin American and African) and when ethnicity is unspecified.
Age: the client's age as of the date of injury.
Treatment Facility: the setting where the treatment injury occurred.
Active claims: a claim that is open and has received a payment in that financial year.
Injury type: the type of injury caused by treatment.
Infections following surgical procedures: infections that occur following surgical procedures (e.g. skin lesion removal, and hip and knee surgery).
Line infections: infections caused by central or peripheral (IV) lines.
Other infection: infections other than infections following surgical procedures and line infections, such as gastrointestinal infections.
Pressure injuries: localized damage to skin/and or underlying tissue caused by pressure. Accepted for cover when clinical teams failed to assess the risk of pressure injury or failed to provide interventions to avoid the pressure injury.
Medication adverse reactions: reactions to medications such as antibiotics and pain relievers.
Medication errors: errors in prescribing and/or dispensing medication.
Pulmonary embolism: a clot forms in the bloodstream then travels to the lungs.
Deep vein thrombosis: a formation of blood clot in a deep vein. This can commonly be in the leg.
Neonatal encephalopathy: a syndrome of disturbed neurological function in a new-born. This term includes cerebral palsy, hypoxic-ischaemic encephalopathy, and stillbirth.
Equipment failure: injuries that occur when equipment, devices or tools used as part of the treatment process have failed. Two examples of equipment failure are equipment breakage and mechanical failure.
Treatment omission: failure to diagnose, to follow-up, to provide treatment, to refer, to monitor, and to provide the right treatment.
Surgical mesh: surgical mesh is a medical device most commonly used for abdominal surgical wounds such as hernia repairs. Mesh has also been used for plastic surgery work, stress urinary incontinence and pelvic organ prolapse. Mesh-related injuries include infections with or without reason, and damage to other organs.

The treatment injury claims data reflects the information held as at February 2019 – for claims lodged from 1 July 2005 to 30 June 2018. All ACC claims data (including treatment injury claims data) is subject to revisions over time. For example, the claim numbers may change as a result of the review or appeal of an ACC decision.

https://www.acc.co.nz/assets/provider/2de075da69/supporting-treatment-safety-report-2019.pdf

Any instances of client gender or age that are missing are not included in the information.
The detailed breakdown of injury types only includes those that are most clinically meaningful. The sum of claims by injury type is, therefore, lower than the actual total.

Both an underlying disease and other pre-existing diseases are not covered – although a significant worsening of disease caused by treatment may be covered.
Also excluded are:
- a necessary part of the treatment (for example, a skin puncture or surgical incision or the removal of a body part when those are a necessary part of the treatment required)
- the ordinary consequences of treatment (for example, hair loss following chemotherapy or radiotherapy burns are unlikely to be covered)
- injury caused solely by decisions about allocating health resources (such as waiting list delays for joint replacement surgery)
- injury caused because a patient unreasonably delayed or refused to give consent for treatment that does not achieve the desired result.

At URL provided, select 'Treatment Injury Data' under the 'Data and Resources' header.

Accident Compensation Corporation (ACC) Treatment Injury Data contains ACC claims relating to personal injury caused by treatment from, or at the direction of, a registered health professional.
This includes:
- diagnosis, advice and interventions
- failure to provide treatment or failure to provide treatment in a timely manner. The injury must have been caused by treatment; but not be a necessary part, or ordinary consequence, of the treatment.

ACC’s treatment injury claims information is based on data collected via the ACC45 and ACC2152 forms. An ACC45 Injury Claim Form is completed by all clients to lodge a claim with ACC, often with the assistance of a treatment provider. For a treatment injury claim, a treatment provider also completes an ACC2152 form, to provide clinical information to support the claim.