Dental Practice and Negligence Claims

Question 1

potential causes for patient to complain about a dentist

Answer 1

• Screw ups, slips, lapses, mistakes
• Deficiency in clinical standard
• Unnecessary treatment
• Confidentiality breach
• Proper consent not obtained – not obtained and recorded well
• Unprofessional manner
• Inappropriate conduct

Question 2

what are the different court, hearings and inquiries that can arise due to a complaint?

Answer 2

• Criminal investigation
• Clinical negligence claim
• Complaint to GDC; re. fitness to practise
• Scottish Public Sector Ombudsman (SPSO) hearing
• Fatal Accident Inquiry / Coroner’s Inquest
• Local complaint

Question 3

what does the Scottish Public Sector Ombudsman deal with?

Answer 3

all services pretty much

health, education, fire, council

Question 4

what is the basic definition of negligence?

Answer 4

‘The omission to do something which a reasonable [practitioner] would do; or, doing something which a reasonable [practitioner] would not do.’

You must take reasonable care to avoid acts or omissions which you can reasonably foresee would be likely to injure your neighbour.
- Do something which is negligent or omission to do something to be negligent

Question 5

who can be your ‘neighbour’?

Answer 5

persons who are so closely and directly affected by my act that I ought reasonably to have them in contemplation as being so affected when I am directing my mind to the acts and omissions that are called in question.

Question 6

what is a defence against a claim in negligence?

Answer 6

if [the dentist] has acted in accordance with a practice accepted as proper by a responsible body of [dental practitioners] skilled in that particular art.’

• if other dentists of the same level would’ve acted in the same way

Question 7

is experience taken into account in negligence claims?

Answer 7

no

Newly registered dentist held to the same standard as experienced ordinary dentist (e.g. not consultant a normal GDP)
Training time doesn’t give leeway

Question 8

what are the 4 points that need breached for clinical negligence

Answer 8

1. The dentist owed a duty of care
2. The duty was breached (standard of care)
3. That breach caused or materially contributed to damage (causation)
4. This damage was reasonably foreseeable and had negative consequences and effects

Question 9

when does a dentist owe a ‘duty of care’?

Answer 9

– as soon as person accepted/registered as a patient

Question 10

when is the duty of care breached?

Answer 10

– practice didn’t meet accepted standard;

GDC and expert witnesses decide on standard (other dentists giving evidence on their opinion if other competent dentist would do it)

Question 11

what is the causation of a negligence claim?

Answer 11

– harm caused by that specific thing – need to be related to dental surgery breach of standard – can get unavoidable pain

Question 12

standard of proof in criminal case

Answer 12

beyond reasonable doubt

Question 13

standard of proof in civil case

Answer 13

balance of probabilities

- lower standard

Question 14

what type of law is relevant to dentistry?

Answer 14

civil

Question 15

what can a dentist do to try and protect themselves?

Answer 15

• Read and understand GDC guidance
• Keep up to date
• Communicate well with patients and colleagues (including proper apologies)
• Follow official policy and procedure
• Ask for help / seek advice when unsure
• Document advice + all relevant details carefully - HAVE GOOD, LEGIBLE NOTES

Question 16

what should a dentist not do in an attempt to protect themselves from the law?

Answer 16

• Be rude to patients or colleagues
• Enter false details in the records — these are thoroughly checked in the event of litigation!
• Change records to cover your tracks
• Attempt to defend mistakes in response to a complaint (this is different from an apology)

Question 17

what is The Standard in Scotland?

Answer 17

Negligence is established where a dentist’s practice fails to meet the standard in the following way:

1. There is a usual and normal practice
2. The dentist did not adopt that practice
3. The course the dentist adopted is one which no dentist of ordinary skill would have taken if acting with ordinary care.

Question 18

what is needed for their to be a negligence claim?

Answer 18

harm
results from dental treatment that is negligent if the dentist’s practice fails to meet the standard of ordinary care
- breach the 4 necessary factors for negligence

Question 19

what are the 4 breaches needed for there to be negligence?

Answer 19

1. The dentist owed a duty of care
2. The duty was breached (= standard of care)
3. That breach caused or materially contributed to damage (= causation)
4. This damage was reasonably foreseeable and had negative consequences and effects (= foreseeability, anticipated. Duty is to take steps to help prevent it happening)

Question 20

when will a dentist not have a duty of care?

Answer 20

if not their patient
- May give them options of where to go – A&E; on call dentists; emergency clinics (they have different duty of care as they treat all that come in)

If you examine them – now have duty of care

Question 21

why is foreseeability a necessary factor for negligence?

Answer 21

Duty is to take steps to help prevent it happening - harm could have been anticipated and thus prevented

Question 22

harm from dental treatment is

Answer 22

harm that results from dental treatment is negligent if the dentist’s practice fails to meet the standard of ordinary care.

Question 23

basic things dentists shouldn’t do to protect themselves

Answer 23

Be rude to patients or colleagues

Enter false details in the records — these are thoroughly checked in the event of litigation!

Change records to cover your tracks

Attempt to defend mistakes in response to a complaint (this is different from an apology)