Medical negligence Flashcards
cause of medical negligence claim: adverse clinical outcome
unexpected personal injury/clinical condition
worsening clinical condition
increased length of hospital stay
unplanned re-admission to hospital
transfer to intensive care unit
death of a patient
professional basis of duty of care
proper clinical assessment of patient
observing limits of clinical competence
updating professional medical knowledge and clinical skills
appropriate clinical treatment and drug prescribing
maintaining clear and accurate clinical records
accessible ti fellow healthcare professionals
consulting with clinical care team
clinical referral of patient for second opinion
the duty of care and the medical practitioner
appropriate levels of clinical skills, knowledge and ability
adequate clinical instruction, training and supervision
provision of suitable clinical equipment in working order
safe working conditions and maintenance of patient safety
safe and secure access to and storage of clinical records
failure of professionalism in medical practice
NHS complaints procedures
parliamentary and health service ombudsman
clinical negligence scheme for trusts (CNST)
membership and level of clinical risk
solicitor firms panel
reporting guidelines
formal investigation
pro-active steps
five year plan
pro active steps
admission
settlement
apology
five year plan
early resolution
risk management principles
legal basis for medical negligence claim
medical practitioner owed claimant patient a duty of care
medical prcatitioner breached the duty of care by non-observance of appropriate standard of care
claimant patients harm/injury was reasonably foreseeable from the breach of duty of care
law of medical negligence: duty of care
medical practitioner owes the patient a duty of care
duty of care covers all aspects of the clinical treatment of a patient
medical pratiotner must prove that they have the clinical skill and medical knowledge required professional practice
medical practitioner should take reasonable care to avoid acts or omission which they could reasonably force would cause harm or injury
patient may be directly or indirectly affected by the act or omission of the medical practiotner
establishing the duty of care
was it reasonably foreseeable that the defendant medical practitioner would cause the patient harm or injury
is there a sufficiently close professional relationship between the medical practiotenr and the patient
is there a public policy against establishing a duty of care
the duty of care to third parties
di marco v Lynch homes, non-identifiable third party
reisner v regents of university of California, identifiable third party
PD v Harvey and chen, disclosure of HIV status of patient
R v kelly , reckless causing of injury
R v dica, reckless infection GBH
JD v east Berkshire NHS trust, alleged minor abuse
breach of duty of care standard of care
medical rpactioner is not guilty of medical negligence if they have used an appropriate clinical practice endorsed by a respected group of medical practitioners
examples of breach of duty of care standard of care
bolam v frieri hosptial management committee
bellarby v worthing and southland NHS trust
maynard v West Midlands regional health authority
bellarby v worthing and southland NHS trust
professional endorsement of clinical practice by expert clinical witness
maynard v West Midlands regional health authority
non-selection of expert clinical witness evidence by presiding judge
legal applicability of Bolam principle
diagnosis of clinical condition
appropriate clinical treatment
non-legal applicability of Bolam principle
informing patient of clinical treatment options
informing patient of clinical risks
formulation of basic diagnostic decisions
non-clinical/clinical advice
categories of legal case
muller v kings college hospital, pure diagnosis and pure treatment
ministry of justice v Carter, current state of professional knowledge not professional hindsight
respected body of professional opinion
De freitas v o’brien
Bolitho v city and hackney health authority
wisniewki v central Manchester health authority
De freitas v o’brien
no specific number of medical practitioners constitutes respected body of professional opinion
Bolitho v city and hackney health authority
logical clinical basis to respected body of professional opinion
wisniewki v central Manchester health authority
judicial adjudication on legal testimony of expert clinical witness
respected body of professional opinion
burne v A
ecclestone V medway NHS trust q
burne v A
no logical professional basis to clinical practice of GP
ecclestone v medway NHS trust
professional textbook/training manual basis of respected body of professional opinion
respected body of profession opinion part 2
border v lewisham and Greenwich NHS trust
smith V Southampton university hospital NHS trust
border v lewisham and Greenwich NHS trust
judicial rejection of respected body of professional opinion legally permissible
smith V Southampton university hospital NHS trust
judicial reliance on expert clinical witness in legal endorsement of respected body of professional opinion
respected body of professional opinion
Mulholland v medway NHS foundation trust
review of clinical evidence e.g. clinical records and professional guidelines
standard of care and clinical specialisation
stockdale v nicholls
judge v Huntingdon health authority
fallon v wilson
FB v princess Alexandra hospital NHS trust
wisher v Essex area health authority
horton v evans
antoniades v st Georges Nos trust
meiklejohn v st Georges NHS trust
stockdale v nicholls
judicial assessment on medical profession and degree of clinical specialisation
judge v Huntingdon health authority
clinical failure to identify unusual symptoms is medical negligence
fallon v wilson
clinical failure to identify unusual symptoms in vulnerable groups of patients is medical negligence
FB v princess Alexandra hospital NHS trust
no medical negligence if under clinical direction of senior colleague
wilsher v Essex area health authority
legal duty of junior medical staff to raise patient safety issues
horton v evans
legal duty of junior medical staff to double check clinical instructions in patient care plan
antoniades v st Georges NHS trust
head of clinical team has professional and clinical responsibility
meiklejohn v st georges NHS trust
professional standard of care not personal/ professional reputation is legal basis of standard of care
standard of care and clinical emergencies
Mulholland v medway NHS foundation trust
wood v Thurston
Garcia v st marys NHS trust
DF healthcare v st Georges healthcare trust
WBA FC v El-safty
Mulholland v Medway NHS Foundation Trust
Differing Standard of Care in Clinical Emergency to Outpatient Appointment)
Wood v Thurston
(Appropriate Clinical Observation of Patient is Legal Basis of Standard of
Care)
Garcia v St Mary’s NHS Trust
Provision of Finance & Clinical Resources by Trust NOT Legally Relevant)
DF Healthcare v St George’s Healthcare Trust
(Professional Compliance with Trust Clinical Policies & Procedures a
Legal Requirement
WBA FC v El-Safty
(Non-Adherence & Significant Deviation from National Guidelines is
Clinical Negligence)
Res Ipsa Loquitor/Facts Speak for Themselves
Lillywhite v UCL NHS Trust
Ratcliffe v Plymouth & Torbay Health Authority
Lillywhite v UCL NHS Trust
(Legal Requirement for Submission of Full & Complete Legal Evidence by
Claimant Patient)
Ratcliffe v Plymouth & Torbay Health Authority
(Legally Applicable with Legal Evidence of Serious & Irrefutable Clinical Error
law of medical negligence: causation
A Claimant Patient must prove Causation in a Medical Negligence
Claim.
A Causal Link between the Medical Practitioner’s Medical
Negligence and the Harm or Injury suffered by the Claimant Patient
must be Legally Proven.
Thomson v Bradford
Establishing A Causal Link: Legal Burden of Proof
Less v Hussain
Davies v Countess of Chester Hospital NHS Trust
Kay v Ayrshire
Less v Hussain
(Legal Claim based on Allegation of Misdiagnosis/Poor Clinical Management)
Davies v Countess of Chester Hospital NHS Trust
(No Legal Proof of Causal Link if Patient Death Inevitable)
Kay v Ayrshire
Significant Burden of Evidential Proof on Claimant Patient)
The “But For” Legal Test
Bailey v Ministry of Defence
Williams v The Bermuda Hospitals
John v Central Manchester University Hospital NHS Trust
Wright v Cambridge Medical Group
Gouldsmith v Mid-Staffordshire
Bailey v Ministry of Defence
(Material Contribution to Harm/Injury & “But For” Legal Test)
Williams v The Bermuda Hospitals
(Innocent Sepsis on Hospital Admission & Guilty Sepsis due to Delayed
Clinical Diagnosis)
John v Central Manchester University Hospital NHS Trust
(Clinical Negligence is a Material Contribution even if NOT Sole Cause of
Harm/Injury)
Wright v Cambridge Medical Group
(Delayed Specialist Referral led to Harm/Injury though NOT Sole Cause of
Harm/Injury)
Gouldsmith v Mid-Staffordshire
(Non-Clinical Referral by GP led to Harm/Injury i.e., “More Likely Than
Not” Provision of Appropriate Clinical Treatment to Patient with Clinical
Referral)
Hayes v South East Coast Ambulance Service
Failure to Diagnose Life-Threatening Condition;
Failure to Observe Clinical Guidelines;
Failure to Undertake Clinical Observations; and
Failure to Clinically Administer Appropriate Medication
break in the causal link: the new intervening act
There may be a Break in the Causal Link, i.e. “A New Intervening Act”
where a Third Party breaks the Causal Link the Medical Practitioner’s Act(s) or Omission(s) and the Harm or Injury suffered
by the Patient.
The New Intervening Act may be Voluntary or Involuntary.
example of the new intervening act q
Prendergast v Sam & Dee
(Apportionment of Legal Liability between GP and Pharmacist)
R v Croyden Health Authority
(Non-Disclosure of Clinical Abnormality & Subsequent Pregnancy NOT
New Intervening Act)
