Medical Negligence Flashcards
What is medical negligence?
A lack of reasonable care and skill as a result of which the patient suffers
What can happen if a citizen has experienced negligence in their standard of care?
The individual may sue in the civil Courts for compensation, and if successful will be awarded damages (money)
How can the medical negligence settlement take place?
Out of court”
Or
An action may proceed through the Civil Courts before a judge
What must be demonstrated to fulfil the definition of medical negligence?
- A legal duty to provide care and skill
- Reasonable care and skill
- Actual Damage must have occurred as a direct result of the lapse
What does A legal duty to provide care and skill encompass?
A professional relationship, which in legal terms is a contract
What are the 2 types of contract?
- Express contract- stating the procedure, the risks and complications
- Implied contract- bring patient medication and they take it, no question
What does reasonable care and skill encompass?
The concept of accepted medical practice
a mistake made by the practitioner must be an error which no competent doctor in that field would have made.
What does damage as a direct result of the lapse encompass?
To prove causation the pursuer must show that, on the balance of probabilities, the alleged negligence caused the damage.
What are some examples of losses leading to compensation?
- Loss of earnings
- Expenses incurred
- Impaired enjoyment of life
- Permanent incapacity
- Procreative incapacity
- Pain and suffering endured
- Death
What are some lines of defence for a charge of negligence?
- Deny the charge
- Patient took a risk – consented procedure
- Contributory Negligence
- True facts but not the pursued doctor’s fault, or vicarious liability
What does contributory negligence include?
Claimant’s own negligence contributed to their loss or damage
What does vicarious liability mean?
A person can be held liable for the actions of another person (e.g. Health Board can be held responsible for the actions of the doctor
What are some strategies for avoiding/minimalizing the risk of complaints of negligence?
- Join a medical defence organisation (MDDUS, MDU, MPS)
- Seek advice early
- Maintain good records
- Delegation
- Comments about colleagues
- Courtesy and hostility
- Report early to Defence Organisation
What does Quintuple jeopardy include?
- Local Complaints
- Disciplinary action - employer
- Civil claim
- Medical Council
- Criminal prosecution
When might a patient make a local complaint?
- Error
- Grief
- Poor understanding/ poor explanation
- Patient has unrealistic expectations of recovery
- Failure of doctor to appreciate needs/wishes of patient
What does the GMC state in regards to local complaints?
You have a professional responsibility to deal with complaints constructively and honestly
You should co-operate with any complaints procedure which applies to your work
You must not allow a patient’s complaint to prejudice the care or treatment you provide or arrange for that patient
You should apologise where appropriate
What can be the implications of a local complaint?
Disciplinary actions might be carried out by the employer
What are the disciplinary actions centred around?
Terms and conditions of service
When do you need to declare complaints made against you?
Every year at appraisal
What happens if a local complaint escalates?
It can escalate to a civil claim
Why are civil claims more common in the US than in the UK?
- No well developed free socialised health care system
- Contingency Fee system for lawyers
- UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue
What can happen if a civil claim escalates?
The GMC can get involved
What happens if the GMC gets involved?
- At the GMC the complaint is considered by case workers
- May be passed onto Case Examiners - investigate if your “honesty and probity” are in question
- Various sanctions can be imposed
- All parties have a right of appeal
Who hears the cases if the medical council gets involved?
Medical Practitioners Tribunal Service (MPTS)
