Medical negligence Flashcards

1
Q

cause of medical negligence claim: adverse clinical outcome

A

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

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2
Q

professional basis of duty of care

A

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

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3
Q

the duty of care and the medical practitioner

A

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

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4
Q

failure of professionalism in medical practice

A

NHS complaints procedures
parliamentary and health service ombudsman

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5
Q

clinical negligence scheme for trusts (CNST)

A

membership and level of clinical risk
solicitor firms panel
reporting guidelines
formal investigation
pro-active steps
five year plan

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6
Q

pro active steps

A

admission
settlement
apology

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7
Q

five year plan

A

early resolution
risk management principles

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8
Q

legal basis for medical negligence claim

A

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

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9
Q

law of medical negligence: duty of care

A

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

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10
Q

establishing the duty of care

A

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

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11
Q

the duty of care to third parties

A

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

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12
Q

breach of duty of care standard of care

A

medical rpactioner is not guilty of medical negligence if they have used an appropriate clinical practice endorsed by a respected group of medical practitioners

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13
Q

examples of breach of duty of care standard of care

A

bolam v frieri hosptial management committee
bellarby v worthing and southland NHS trust
maynard v West Midlands regional health authority

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14
Q

bellarby v worthing and southland NHS trust

A

professional endorsement of clinical practice by expert clinical witness

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15
Q

maynard v West Midlands regional health authority

A

non-selection of expert clinical witness evidence by presiding judge

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16
Q

legal applicability of Bolam principle

A

diagnosis of clinical condition
appropriate clinical treatment

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17
Q

non-legal applicability of Bolam principle

A

informing patient of clinical treatment options
informing patient of clinical risks
formulation of basic diagnostic decisions
non-clinical/clinical advice

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18
Q

categories of legal case

A

muller v kings college hospital, pure diagnosis and pure treatment
ministry of justice v Carter, current state of professional knowledge not professional hindsight

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19
Q

respected body of professional opinion

A

De freitas v o’brien
Bolitho v city and hackney health authority
wisniewki v central Manchester health authority

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20
Q

De freitas v o’brien

A

no specific number of medical practitioners constitutes respected body of professional opinion

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21
Q

Bolitho v city and hackney health authority

A

logical clinical basis to respected body of professional opinion

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22
Q

wisniewki v central Manchester health authority

A

judicial adjudication on legal testimony of expert clinical witness

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23
Q

respected body of professional opinion

A

burne v A
ecclestone V medway NHS trust q

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24
Q

burne v A

A

no logical professional basis to clinical practice of GP

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25
Q

ecclestone v medway NHS trust

A

professional textbook/training manual basis of respected body of professional opinion

26
Q

respected body of profession opinion part 2

A

border v lewisham and Greenwich NHS trust
smith V Southampton university hospital NHS trust

27
Q

border v lewisham and Greenwich NHS trust

A

judicial rejection of respected body of professional opinion legally permissible

28
Q

smith V Southampton university hospital NHS trust

A

judicial reliance on expert clinical witness in legal endorsement of respected body of professional opinion

29
Q

respected body of professional opinion

A

Mulholland v medway NHS foundation trust

review of clinical evidence e.g. clinical records and professional guidelines

30
Q

standard of care and clinical specialisation

A

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

31
Q

stockdale v nicholls

A

judicial assessment on medical profession and degree of clinical specialisation

32
Q

judge v Huntingdon health authority

A

clinical failure to identify unusual symptoms is medical negligence

33
Q

fallon v wilson

A

clinical failure to identify unusual symptoms in vulnerable groups of patients is medical negligence

34
Q

FB v princess Alexandra hospital NHS trust

A

no medical negligence if under clinical direction of senior colleague

35
Q

wilsher v Essex area health authority

A

legal duty of junior medical staff to raise patient safety issues

36
Q

horton v evans

A

legal duty of junior medical staff to double check clinical instructions in patient care plan

37
Q

antoniades v st Georges NHS trust

A

head of clinical team has professional and clinical responsibility

38
Q

meiklejohn v st georges NHS trust

A

professional standard of care not personal/ professional reputation is legal basis of standard of care

39
Q

standard of care and clinical emergencies

A

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

40
Q

Mulholland v Medway NHS Foundation Trust

A

Differing Standard of Care in Clinical Emergency to Outpatient Appointment)

41
Q

Wood v Thurston

A

(Appropriate Clinical Observation of Patient is Legal Basis of Standard of
Care)

42
Q

Garcia v St Mary’s NHS Trust

A

Provision of Finance & Clinical Resources by Trust NOT Legally Relevant)

43
Q

DF Healthcare v St George’s Healthcare Trust

A

(Professional Compliance with Trust Clinical Policies & Procedures a
Legal Requirement

44
Q

WBA FC v El-Safty

A

(Non-Adherence & Significant Deviation from National Guidelines is
Clinical Negligence)

45
Q

Res Ipsa Loquitor/Facts Speak for Themselves

A

Lillywhite v UCL NHS Trust
Ratcliffe v Plymouth & Torbay Health Authority

46
Q

Lillywhite v UCL NHS Trust

A

(Legal Requirement for Submission of Full & Complete Legal Evidence by
Claimant Patient)

47
Q

Ratcliffe v Plymouth & Torbay Health Authority

A

(Legally Applicable with Legal Evidence of Serious & Irrefutable Clinical Error

48
Q

law of medical negligence: causation

A

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

49
Q

Establishing A Causal Link: Legal Burden of Proof

A

Less v Hussain
Davies v Countess of Chester Hospital NHS Trust
Kay v Ayrshire

50
Q

Less v Hussain

A

(Legal Claim based on Allegation of Misdiagnosis/Poor Clinical Management)

51
Q

Davies v Countess of Chester Hospital NHS Trust

A

(No Legal Proof of Causal Link if Patient Death Inevitable)

52
Q

Kay v Ayrshire

A

Significant Burden of Evidential Proof on Claimant Patient)

53
Q

The “But For” Legal Test

A

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

54
Q

Bailey v Ministry of Defence

A

(Material Contribution to Harm/Injury & “But For” Legal Test)

55
Q

Williams v The Bermuda Hospitals

A

(Innocent Sepsis on Hospital Admission & Guilty Sepsis due to Delayed
Clinical Diagnosis)

56
Q

John v Central Manchester University Hospital NHS Trust

A

(Clinical Negligence is a Material Contribution even if NOT Sole Cause of
Harm/Injury)

57
Q

Wright v Cambridge Medical Group

A

(Delayed Specialist Referral led to Harm/Injury though NOT Sole Cause of
Harm/Injury)

58
Q

Gouldsmith v Mid-Staffordshire

A

(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)

59
Q

Hayes v South East Coast Ambulance Service

A

Failure to Diagnose Life-Threatening Condition;
Failure to Observe Clinical Guidelines;
Failure to Undertake Clinical Observations; and
Failure to Clinically Administer Appropriate Medication

60
Q

break in the causal link: the new intervening act

A

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.

61
Q

example of the new intervening act q

A

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)