**3. The Danish patient insurance law**

In Denmark, patients or relatives may file a claim if their medical treatment results in an injury or an unexpected side effect. The independent Danish Patient Insurance Pathophysiology and Clinical Aspects of 160 Venous Thromboembolism in Neonates, Renal Disease and Cancer Patients

A special variety of the disease exists, where an obstruction is present at the iliac venous junction. This is called the *left iliac vein syndrome*, and it is normally not associated with pulmonary embolism, as the lumen of the left common vena iliaca is partially obstructed by a fine net of the endothelium at the junction. The compression from the crossing of the right

In some cases the source of embolism is located in a venous malformation, and the thrombi to the lungs may be small and not easily clinically detectable. The pressure in the pulmonary artery increases slowly over months with the continuing pulmonal embolization causing cronical *cor pulmonale*. The *foramen ovale* may open under the increased pressure in the right side of the heart, releasing minor emboli to the arterial circulation. The end result is usually cardiac arrest due to the increased pressure with

In rare cases the thrombosis occurs in the veins of the upper extremity. The size of emboli from the arms is not sufficient to give any serious problem from the lungs, but it is

Thombosis in the mesenteric veins is a very rare, but potentially deadly disease. The onset of symptoms is much slower than that of arterial vascular iscaemia, where as a rule you have only 6 hours from the embolization to completion of thrombectomy, if gangrene and resection should be prevented. In venous ishaemia there are often days or weeks of symptoms before the onset of gangrene, and if the ischaemia has progressed to gangrene, a simple resection will often be sufficient. Venous intestinal ischaemia is usually not recognized until laparotomy, and it may be very difficult to make the diagnosis by

Thrombosis in the venous sinuses of the brain is an important side effect to birth control drugs, and must always be considered as a differential diagnosis when a patient on the pill

Finally, another inborn vascular anomaly has bearing on the embolisation from the veins of the lower limbs: The *foramen ovale*, which normally closes at the time of birth, will sometimes remain open and allow emboli from the right side to cross over to the left side and continue in the arterial system. This is known as "paradox" embolisation, and is important to consider, when a patient at risk for venous thrombosis suffers an arterial embolus. The frequency of patent *foramen ovale* in autopsy studies is about 20 %, so this a significant risk,

The disease known as thrombophlebitis, where a subcutaneous vein is inflamed and thrombosed, has nothing in common with DVT. In the major part of the 20th century it was thought that thrombosis might spread from the superficial veins to the femoral venous system through the sapheno-femoral junction, wherefore acute ligature of the junction was advised. This indication for the sapheno-femoral ligature has since been abandoned. Also,

In Denmark, patients or relatives may file a claim if their medical treatment results in an injury or an unexpected side effect. The independent Danish Patient Insurance

common iliac artery adds to the obstruction.

important to know that this possibility exists.

dilation of the right ventricle.

laparoscopy alone.

develops symptoms from the brain.

**3. The Danish patient insurance law** 

as the frequency of deep venous thrombosis is equally high (1).

the practice of anticoagulation with thrombophlebitis is no longer advised.

Association (DPIA) will consider these claims. The DPIA operates on a no-blame, no-fault basis and does not take any legal action beyond assessing damages. As a result, patients may file a claim with the DPIA free of charge with the sole purpose of seeking financial compensation. Thus, the injured patient is spared the expense of legal fees and the trouble of going to court (2).

In general, financial compensation may be granted under any one of the following conditions:


Compensation is calculated based on the extent of pain and suffering, reduced income, reduced ability to work, and medical expenses as well as whether the injury could be expected to be permanent. Compensation is rendered if the calculated amount exceeds 1,500 €. The government pays the compensations. After the decision has been made, the patient may file an appeal to the Patient Damage Appeal Board and further through the courts of law. From 1996 to 2010, the DPIA received 64.400 claims; 34.9 % of these were approved.
