Medical negligence Flashcards
What is the GMC’S statutory responsibility?
is to produce the Medical Register – its membership
The GMC is responsible for overseeing and certifying the appropriateness of medical education
What are some topics the GMC guidance includes? (9)
Ethics Professionalism Professional Governance The Law as it affects and governs medical practice Confidentiality Consent Negligence Record Keeping Team working
What does the GMC guidance basically mean? (8)
Putting patients first Being honest Having the knowledge to practise medicine legally Knowing one’s limitations Being knowledgeable and keeping up to date Treating people with dignity Treating people consistently Being able to admit you are wrong
What Relevance Does Legislation have to Working as a Doctor?(7)
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 is the Quintuple Jeopardy? - complaint list
Local Complaints Disciplinary action - employer Civil claim Medical Council Criminal prosecution
What are local complaints?
why might a patient complain?
Lowest level - Patients have a right to complain, (error, grief poor explanation, unrealistic expectations, failure to meet wishes of patient)
with local complaints what must you do ?
reply - the first response back is crucial
Disciplinary action - employer? what are the procedures
Terms and conditions of service Appraisal Job planning Time keeping Absence
Civil claim? why are there differences between the UK and U.S
NHS - care regardless of income or insurance
Jury involved – someone to blame
UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue
general medical council - complaints - what is the process?
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
Cases heard by the Medical Practitioners Tribunal Service (MPTS)
Various sanctions can be imposed
All parties have a right of appeal
What can some GMC cases include? (6)
Manner and attitude Dishonesty Sexual impropriety Criminal convictions Health issues – drink driving/abuse of drugs/mental health Significant Performance issues
Criminal prosecution? types of criminal prosecution?
Indecent assault Prescription fraud Manslaughter Murder Deception offences
What is civil law?
concerned with the rights and property of individual people or organisations, which may not always be protected by criminal laws.
What does civil law dispute?
settles disputes between individuals and organisations, and it often involves compensation being awarded.
Examples of civil law cases?
Family disputes, such as divorce, dissolution of civil partnerships, children’s issues and childcare arrangements
Personal injury cases, such as road traffic accidents, medical and clinical negligence and slips, trips and falls
Breach of contract or promise, such as cases where money is unpaid or a contract isn’t honoured
Employment law, for example where an employee suffers discrimination
What is criminal law?
relates to offences and breaches that negatively affect society as a whole, rather than just one person - can get criminal prosecution from the state
Crown court in scotland - 2 types?
Sheriff - not usually a jury, lesser crimes/shorter punishment - theft, assault - 4 year prison sentences
High court - jury, judge can hand out large sentences
What can medical negligence be defined as?
a lack of reasonable core and skill as a result of which the patient suffers
The monetary award will reflect what?
financial loss (occasioned by inconvenience or injury) suffered by the patient and not the degree of negligence exhibited, the reason for the lapse being immaterial
What are the 3 main components of medical negligence
legal duty - contract
reasonable care and skill
actual damage
Legal duty- what does this mean?
to provide care and skill i.e. a professional relationship, which in legal terms is a contract
Express contract
Implied contract
Reasonable Care and Skill - basically means what?-
The concept of accepted medical practice - an error that no other competent doctor would make
the 2 medical negligence cases?
Hunter v Hanley 1955
Bolam V Friem 1957
Actual damage?
must have occurred as a direct result of the lapse ie causation
The negligence has caused the Damage!!!!
Medical negligence - examples of losses leading to compensation? (7)
Loss of earnings Expenses incurred Impaired enjoyment of life Permanent incapacity Procreative incapacity Pain and suffering endured Death
Procedures Upon Complaint of Negligence - STEPS (4)
- complaint to solicitor - looks into allegations and if there is substance will represent complaint to doctor in writing
- Doctor - legal representatives (Defence Organisation, Health Authority etc)
- no case, some negligence (self-evident)
- neither of above - civil court
Medical negligence - lines of defence (4)
Deny the charge
True facts but not the doctors fault
Patient took a risk - consented procedure
Contributory negligence - claimant’s own negligence contributed to loss or damage
What is vicarious liability
Vicarious liability - where a person can be heldliablefor the actions of another person (e.g. Health Board can be held responsible for the actions of the doctor
What is involuntary manslaughter?
causes death but without intent to kill This charge does not exist in Scotland – ? Involuntary culpable homicide – homicide in the course of lawful conduct
What does gross negligence manslaughter mean?
breached duty of care with foreseeable serious risk of death ensuing and actions or contributions caused or significantly contributed to death of the victim
Strategies for avoiding/minimal 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
