ABSTRACT: In June 2005, the Study Centre of the German Surgical Society (SDGC) in Heidelberg, Germany, agreed to participate in the investigator initiated trial CRASH2. Regulatory and administrative affairs within Germany were assigned to the Coordination Centre for Clinical Trials (KKS) at the University of Heidelberg, Germany. For more than nine months the KKS and the SDGC have been trying to procure a separate insurance for CRASH2 in Germany. Unfortunately, these attempts have not been successful, yet. One major reason is the way in which German authorities and authorities of some other countries have interpreted the EU Directive (Directive 2001/20/EC) with regards to the need for "adequate" indemnity for clinical trials. The indemnity insurance for CRASH2 procured by the LSHTM for all participating hospitals throughout the world (except for the USA) did not comply with the limits required by the federal German drug law (AMG).