Medical Negligence Flashcards
What is the role of the GMC?
- Oversee and certify medical education
- Produce the medical register
- Ensure doctors are fit to practice
What is the relevance of legislation on the work of a doctor?
- Working legally and lawfully
- Duty of care to the patient
- Working with proper skill and attention
- Risk versus benefit analysis
- Working in a patient’s best interests
- Working within one’s own capabilities
- Achieving expected outcomes
What are the 5 levels of patient complaint?
- Local Complaints
- Disciplinary action - employer
- Civil claim
- Medical Council
- Criminal Prosecution
Why might a patient make a complaint?
- Error
- Grief
- Poor understanding/explanation
- Unrealistic expectations
- Failure to appreciate needs/wishes
What is a doctors professional responsibility towards local complaints?
Must reply - deal with complaints constructively and honestly
Cooperate with any complaints procedure
Do not allow the complaint to prejudice care provided to the patient
When appropriate, offer apology
What are the disciplinary procedures of employers?
- Terms and conditions of service
- Appraisal
- Job planning
- Time keeping
- Absence
What factors explain the differences in litigation between the UK and the USA?
- Socialised healthcare
- Jury involved
- Contingency fee for lawyers
- Public expectation
- NHS UK complaints procedures permit interaction and explanation for patients without the need to sue
What is the largest cause of medical litigation in the USA?
Lack of communication between the doctor and the patient
What cases may be covered by the GMC?
- Manner and attitude
- Dishonesty
- Sexual impropriety
- Criminal convictions
- Health issues – drink driving/abuse of drugs/mental health
- Significant Performance issues
What types of criminal allegations are made against doctors?
- Indecent assault
- Prescription fraud
- Manslaughter
- Murder
- Deception offences
What is civil law?
Concerned with rights and property of individual people/organisations - may not always be criminal
Often involved compensation
Civil law cases depend on what?
Establishing whether or not the accused person or organisation (defendant) had a duty of care towards the claimant
What is criminal law?
Relation to offenses that negatively affect society as a whole
Brought by the Crown Prosecution Service
- Burglary/theft/arson
- Assault
- Murder
- Fraud
How is medical negligence defined?
A lack of reasonable care and skill as a result of which, the patient suffers
What must be demonstrated, in legal terms, to fulfil the definition of medical negligence?
- A legal duty to provide care - contract (express or implied)
- Reasonable care and skill - accepted medical practic
- Actual damage as a result of lapse
Hunter v Hanley 1955 determined what?
Mistake made by the practitioner must be an error which no competent doctor in that field would have made
Bolam v Friern Hospital Management Committee 1957 determined what?
A doctor who acted in accordance with a practice accepted at the time as proper by a responsible body of medical opinion, is not guilty of negligence merely because a body of competent professional opinion might adopt a different technique
Which losses may lead to a compensation?
- Loss of earnings
- Expenses incurred
- Impaired enjoyment of life
- Permanent incapacity
- Procreative incapacity
- Pain and suffering endured
- Death
What are the lines of defence in medical negligence?
- Deny the charge
- True facts but not the persued doctor’s fault/vicarious liability
- Patient took a risk-consented procedure
- Contributory negligence (claimants own negligence led to their loss)
What is vicarious liability?
Where a person can be held liable for the actions of another person
What is Gross Negligence manslaughter?
Accused breached duty of care with foreseeable risk of death/actions causing or significantly contributing to the death of the victim
What were the outcomes of the Bawa-Garba Case 2011?
Policy review of gross negligence manslaughter
Investigating the understanding of the processes and law in gross negligence manslaughter, and its relationship with reflective practice
- Clarify the law
- Improve the use of experts
- Exclusion of reflective material from documentation recoverable by professional regulations
- Removal of GMC right to appeal MPTS decisions
What strategies can a physician undertake to minimalise the risks of complaints of negligence?
Join a medical defence organisation
Seek advice early
Maintain good records
Delegation
Comments about colleagues
Courtesy/hostility
Report early
