**6. VTE and treatment with female hormones**

Pathophysiology and Clinical Aspects of 162 Venous Thromboembolism in Neonates, Renal Disease and Cancer Patients

Complication N N approved Rate of approval Deep venous thrombosis in the legs alone 390 226 58 % Pulmonary embolism 266 176 66 % Rare venous thrombosis 32 19 59 % Total 688 421 61 %

The patients could be divided in 5 sub-categories after the nature of their disease and

**VTE after an open intervention** was the largest group with 391 patients. The cause of injury was usually failing to give the correct prophylaxis, or omitting to give any prophylaxis at

Speciality N invasive procedures N approved Orthopedic surgery 226 128 Surgery 94 52 Internal medicine 23 10 Gynaecology & Obstetrics 18 11 Neurosurgery 13 9 General practice 2 2 OtoRhinoLaryngology 5 5 Anaestesia 3 2 Radiology 4 3 Neurology 1 1 Onchology 1 0 Dental surgery 1 1 Total 391 224

Table 3. The number of patients with VTE treated in the different specialities.

Of these, 27 patients died as result of the injury. There were 224 patients, who had their claims approved by the DPIA. Compensation was paid to 218 patients to the total amount of

There were 42 patients who died because of the patient injury (6.1 %).

Invasive procedures 391 Birth control drugs 193 Other drugs 13 Non-operative fracture treatment 30 Missed diagnosis 15 Rare and miscellaneus 46 Total 688

Table 1. DVT and PE in the material.

Table 2. Categories of patients.

€ 6.127.365.

circumstances surrounding the injury (Table 2).

all. The specialities involved are seen in table 3.

The other large group was 193 patients with DVT or PE, who had birth control medication (173 patients) or treatment of menopausal conditions (20 patients) prescribed by their physician, and suffered VTE as a result. Their claims were approved in 138 cases, and € 2.956.248 was paid to 134 patients. Only 5 women died, but it must be borne in mind that these were completely healthy women. In 17 cases it was later established that the patient had a coagulation defect, usually the Leiden factor-5 mutation.

There were at times several factors that contributed to the onset of thrombosis in these patients. Thus it was discussed which factor was the crucial one, when e.g. a young woman who was on birth control pills and had a body mass index of 34, undertook a long air travel and suffered VTE? The coagulation experts that we have consulted thought that the VTE would not have happened without the birth control medication, and that the contribution of the other factors was minor in comparison.
